目的:探究富马酸丙酚替诺福韦对恩替卡韦治疗后低病毒血症慢性乙型肝炎患者的效果.方法:于 2019 年 1 月—2022 年 12 月选取惠州市中心人民医院收治的 106 例低病毒血症慢性乙型肝炎患者作为研究对象,采用随机数字表法分为两组,各 53 例.所有患者均已接受恩替卡韦抗病毒治疗,对照组继续接受恩替卡韦治疗,观察组换用富马酸丙酚替诺福韦治疗,均持续治疗 24 周.对比两组血清乙型肝炎病毒DNA(hepatitis B virus DNA,HBV-DNA)转阴率、乙型肝炎e抗原(hepatitis B e antigen,HBeAg)阴转率、肝功能、HBV载量、不良反应发生率.结果:治疗 24 周后,观察组HBV-DNA转阴率为 96.23%,HBeAg转阴率为 33.96%,均高于对照组的 16.98%、13.21%,差异均有统计学意义(P<0.05).两组治疗前天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBIL)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、HBV载量对比,差异均无统计学意义(P>0.05);观察组治疗后AST、TBIL、ALT、HBV载量均低于对照组,差异均有统计学意义(P<0.05).观察组不良反应发生率为 7.55%,与对照组的 5.66%比较,差异无统计学意义(P>0.05).结论:富马酸丙酚替诺福韦替换恩替卡韦治疗低病毒血症慢性乙型肝炎患者可提高HBV-DNA、HBeAg阴转率,改善肝功能,降低HBV载量,安全性高.
Effect of Tenofovir Alafenamide Fumarate on Chronic Hepatitis B Patients with Hypoviremia after Entecavir Treatment
Objective:To explore the effect of Tenofovir Alafenamide Fumarate on chronic hepatitis B patients with hypoviremia after Entecavir treatment.Method:A total of 106 chronic hepatitis B patients with hypoviremia treated in Huizhou Central People's Hospital from January 2019 to December 2022 were selected as the study objects,and were divided into two groups by random number table method,with 53 cases in each group.All patients had received Entecavir antiviral therapy,the control group continued to receive Entecavir treatment,and the observation group was replaced with Tenofovir Alafenamide Fumarate treatment,both continuing treatment for 24 weeks.Serum hepatitis B virus DNA(HBV-DNA)negative conversion rate,hepatitis B e antigen(HBeAg)negative conversion rate,liver function,HBV load and incidence of adverse reactions were compared between the two groups.Result:After 24 weeks of treatment,the HBV-DNA negative conversion rate of the observation group was 96.23%,and the HBeAg negative conversion rate was 33.96%,which were higher than 16.98%and 13.21%in the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in aspartate aminotransferase(AST),total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate Aminotransferase(AST)and HBV load between the two groups(P>0.05).After treatment,AST,TBIL,ALT and HBV load in observation group were lower than those in control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 7.55%,compared with 5.66%in the control group,the difference was not statistically significant(P>0.05).Conclusion:Tenofovir Alafenamide Fumarate replacing Entecavir in the treatment of chronic hepatitis B patients with hypoviremia can increase the negative conversion rate of HBV-DNA and HBeAg,improve liver function,reduce HBV load,and have high safety.
万方数据
维普
