【摘要】 目的评价替比夫定与拉米夫定对比治疗慢性乙型肝炎(CHB)的疗效。方法检索2007年4月至2010年8月万方数据、维普资讯、中国生物医学文献数据库,根据纳入标准、排除标准,对入选的6篇随机对照试验(RCT)的研究结果,采用RevMan5.0.2软件进行分析。结果与对照组相比,替比夫定能更显著地提高HBV DNA转阴率、HBeAg转阴率、HBeAg血清转换率和ALT复常率:相对危险度(RR)分别为1.39[95%CI(1.26～1.54),Z=6.45,P<0.00001]、1.46[95%CI(1.16～1.84),Z=3.24,P=0.001]、1.47[95%CI(1.12～1.92),Z=2.77,P=0.006]和1.15[95%CI(1.09～1.22),Z=4.88,P<0.00001];且降低耐药率:优势比(OR)为0.31[95%CI(0.20～0.48),Z=5.15,P<0.00001];而两组不良事件发生率的差异无统计学意义[OR=1.36,95%CI(0.84～2.20),Z=1.27,P=0.20]。结论采用替比夫定与拉米夫定对比治疗CHB患者,能更显著地降低HBV DNA,提高HBeAg血清转阴率、转换率和ALT复常率,降低耐药率,且不增加药物不良反应。更多还原

【Abstract】 Objective To evaluate the treatment of telbivudine compared with lamivudine on chronic hepatitis B patients in china.Methods The papers were searched from April 2007 to August 2010 in the database of wanfangdata,CQVIP and CBM according to inclusion criteria and exclusion criteria.The selected six randomized controlled trials(RCT) findings were analysed by RevMan5.0.2 Software.Results Compared with the control group,telbivudine improved HBV DNA negative rate,HBeAg negative rate,HBeAg seroconversion rate and ALT normalization rate more significant than those of lamivudine: RR were 1.39[95%CI(1.26~1.54),Z=6.45,P<0.00001],1.46[95%CI(1.16~1.84),Z=3.24,P=0.001],1.47[95%CI(1.12~1.92),Z=2.77,P=0.006] and 1.15[95%CI(1.09~1.22),Z=4.88,P<0.00001];Telbivudine can reduce the rate of drug resistance: OR is 0.31[95%CI(0.20~0.48),Z=5.15,P<0.00001];There was no significant difference of the adverse events[OR=1.36,95%CI(0.84~2.20),Z=1.27,P=0.20].Conclusion Telbivudine is more effective in the HBV DNA reduction,increase of serum HBeAg negative rate,conversion rate and ALT normalization rate,with lower resistance rate and without increasing drug adverse reactions compared with lamivudine.更多还原