目的 实验观察替比夫定治疗慢性乙型肝炎(以下简称乙肝)的疗效.方法 将83例慢性乙肝患者分成HBeAg阴性组(40例)和HBeAg阳性组(43例),均首次给予替比夫定抗病毒治疗48周,于治疗0、4、12、24、48周时联检HBV DNA、ALT水平、乙肝两对半,分析上述时间点两组患者HBV DNA转阴率、ALT复常率、e抗原转阴率及血清转换率(又称血清乙肝标志物转换率).结果 HBeAg阴性组治疗4、12、24、48周时HBV DNA转阴率分别为25.00%、47.50%、77.50% 和87.50%;ALT的复常率分别为5.00%、55.00%、80.00% 和97.50%;HBeAg阳性组治疗4、12、24、48周时的HBV DNA转阴率分别为2.33%、16.28%、48.84% 和67.44%;ALT的复常率分别为2.33%、51.16%、79.07% 和93.02%;e抗原转阴率分别为0、16.28%、32.56%和48.84%;血清学转换率分别为0、11.63%、18.60% 和34.88%.结论 替比夫定可明显抑制HBV DNA 的复制,促使ALT回复正常,近期疗效好,对e抗原阴性的初治患者HBV DNA的阴转率更高.%Objective To observe the therapeutic efficacy of telbivudine treatment on chronic hepatitis B. Methods Eighty - three patients, who were given with 48 weeks telbivudine treatment for the first time, were divided into HBeAg negative group ( 40 cases ) and positive group ( 43 cases ). HBV DNA, ALT level, HBV biomarkers were examined at baseline, 4th, 12th, 24th and 48th week. HBV DNA conversion rate. ALT normalization rate , HBeAg conversion rate and seroconversion rate ( HBV - M conversion ratio ) were analyzed. Results In HBeAg negative group, the HBV DNA conversion rates were 25％ , 47％ , 77. 5％ and 87. 50％ , at the 4th, 12th, 24th and 48th week, respectively; while the ALT normalization rates were 5％ , 55％ , 80％ and 97. 5％ , respectively. Meanwhile , in HBeAg positive group, the HBV DNA conversion rates were 2. 3％ , 16. 3％ , 48. 8％ and 67. 4％ , respectively, at the 4th, 12th, 24th and 48th week; while the ALT normalization rates were 2. 3％ , 51. 2％ , 79. 1％ and 93. 0％ , respectively; and the HBeAg conversion rates were 0, 16. 3％ , 32. 6％ and 48. 8％ , respectively; and the seroconversion rate were 0, 11. 63 , 18. 60 and 34. 88％ , respectively. Conclusion Telbivudine effectively inhibits replication of hepatitis B virus, improves HBV DNA conversion, and promotes decline of ALT. In addition, higher efficacy on HBV DNA conversion wtih telbivudine treatment is found in HBeAg negative patients.
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