中国临床药理学杂志2018，Vol.34Issue(10)：1136-1139,4.DOI:10.13699/j.cnki.1001-6821.2018.10.002
恩替卡韦和阿德福韦酯治疗乙型病毒性肝炎相关肝硬化的临床研究
Clinical trial of entecavir combined with adefovir dipivoxil in the treatment of patients with hepatitis B virus-related cirrhosis
摘要
Abstract
Objective To study the impact of entecavir (ETV) combined with adefovir dipivoxil (ADV) on efficacy and nephritic function in the treatment of patients with hepatitis B virus (HBV)-related cirrhosis,to provide the basis for monitoring and optimizing HBV drug.Methods A total of 110 patients who diagnosed with HBV-related cirrhosis were randomly divided into control group (n =55) and treatment group (n =55).Control group was orally given telbivudine 600 mg,qd.Treatment group was given orally entecavir 0.5 mg,qd,combined with adefovir dipivoxil 10 mg,qd.Both groups were lasted for 48 weeks.The HBV DNA level,virologic,serologic and biochemical response,liver fibrosis index and eGFR levels before and after treatment were compared between the two groups.Results After 48 weeks treatment,HBV DNA levels were reduced 4.73 log10 U · mL-1,5.32 log10U · mL-1 in control group and treatment group (P ＜0.05).The HBV DNA negative conversion rate,HBeAg negative conversion rate and alanine aminotransferase (ALT) normalization in control group were 69.09％,20.00％,85.45％,had no significant difference with those in treatment group,which were 74.55％,14.55％ and 78.18％.The levels of hyaluronic acid (HA) and procollagen type Ⅲ (PC Ⅲ) were (140.20 ±20.65),(182.10 ± 12.00) ng · mL-1 after treatment in control group,had significant difference with before treatment (P＜0.05).The levels of HA,laminin and PC Ⅲ in treatment group after treatment were (122.40 ± 18.27),(130.90 ± 13.62),(112.10 ± 16.73) ng · mL-1,had significant difference with before treatment (P ＜ 0.05).The level of PC Ⅲ in treatment group had significant difference with control group after treatment (P ＜ 0.05).After 48 weeks treatment,eGFR level in control group was(112.00 ± 16.17)mL/1.73 m2 · min,had no significant difference with those in treatment group,which were (103.00 ± 13.02) mL/1.73 m2 · min (P ＞ 0.05).No obvious drug resistance,adverse drug reaction and renal function change were observed in two groups.Conclusion Compared with telbivudine,entecavir combined with adefovir dipivoxil can show a stronger efficacy for improving liver function in patients with HBV-related cirrhosis.Telbivudine had no significant difference compared with entecavir combined with adefovir dipivoxil in improving nephritic function.关键词
恩替卡韦/阿德福韦酯/替比夫定/乙型病毒性肝炎/肾功能Key words
entecavir/adefovir dipivoxil/telbivudine/hepatitis B/nephritic function分类
医药卫生引用本文复制引用
沈男男,王佳良,劳国琴,石夏莹,王伶,张谊芳,蒋杰..恩替卡韦和阿德福韦酯治疗乙型病毒性肝炎相关肝硬化的临床研究[J].中国临床药理学杂志,2018,34(10):1136-1139,4.基金项目
浙江省药学会医院药学专项科研基金资助项目(2016ZYY29) （2016ZYY29）
绍兴市卫生计生科技创新计划基金资助项目(2016CX010) （2016CX010）
