申纪轩

doi：10.3969/j.issn.1007-614x.2014.23.26

摘 要 目的：探讨替比夫定与阿德福韦酯治疗HBeAg阳性慢性乙型肝炎的临床疗效。方法：2012-2013年收治HBeAg阳性慢性乙型肝炎患者90例，分为观察组及对照组，各45例，观察组应用替米夫定治疗，对照组采用阿德福韦酯治疗，连续治疗24周。结果：观察组肝功能指标改善优于对照组，比较差异有统计学意义（P<0.05）；观察组HBeAg及HBV-DNA转阴率高，与对照组比较差异有统计学意义（P<0.05）。结论：替比夫定治疗HBeAg阳性慢性乙型肝炎疗效优于阿德福韦酯。

关键词 替比夫定；阿德福韦酯；慢性乙型肝炎；HBeAg阳性

Comparative observation on the curative effect of telbivudine and adefovir dipivoxil in the treatment of HBeAg positive chronic hepatitis B

Shen Jixuan

Out-patient Department of the People's Liberation Army 150 Central Hospital，471031

Abstract Objective：To explore the clinical effect of telbivudine and adefovir dipivoxil in the treatment of HBeAg positive chronic hepatitis B.Methods：90 cases of HBeAg positive chronic hepatitis B were selected from 2012 to 2013.They were divided into the observation group and the control group with 45 cases in each.The observation group were treated with telbivudine.The control group were treated with adefovir dipivoxil.They were given continuous treatment for 24 weeks.Results：The liver function of the observation group was better than that of the control group，and the difference was statistically significant（P<0.05）.The negative conversion ratios of HBeAg and HBV-DNA of patients in the observation group were high，and there was significant difference compared with the control group（P<0.05）.Conclusion：Telbivudine in the treatment of HBeAg positive chronic hepatitis B has significant effect，and its effect is superior to adefovir dipivoxil.

Key words Telbivudine；Adefovir dipivoxil；Chronic hepatitis B；HBeAg positive

慢性乙型肝炎是一种持续性、进展性疾病，严重影响患者生活质量。乙型肝炎传染是一个严重的公共卫生问题，对于HBV复制活跃、病情活动的慢性乙型肝炎患者[1]，应进行抗病毒治疗，最大限度清除HBV，减轻炎性反应。本文介绍我院应用替比夫定与阿德福韦酯治疗HBeAg阳性慢性乙型肝炎的临床疗效，现报告如下。

资料与方法

2012-2013年收治HBeAg阳性慢性乙型肝炎患者90例，回顾性分析其资料，按照随机、对照、双盲原则分为观察组及对照组，各45例。观察组男25例，女20例，年龄22～53岁，平均（35.8±2.3）岁；对照组男28例，女17例，年龄21～56岁，平均（38.4±3.6）岁。两组在年龄、性别、病情等方面比较差异无统计学意义（P>0.05）。

入选标准：入选患者符合2000年《病毒性肝炎防治方案》，HBsAg阳性>6个月，有慢性乙型肝炎病毒感染史，排除自身免疫性疾病、酒精性肝病、严重心肾功能不全，伴有恶性肿瘤，及6个月内接受干扰素、免疫调节治疗。

方法：观察组给予替比夫定600 mg/d，对照组给予阿德福韦……