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目的探讨临床有效治疗慢性乙型肝炎患者的方法,以便为慢性乙型肝炎的临床诊治提供参考借鉴。方法选取2012年12月—2014年12月期间院临床收治的慢性乙型肝炎患者78例为研究对象,根据患者临床治疗方案的不同,将患者分成了恩替卡韦组和替比夫定组,两组患者均为39例。恩替卡韦组给予患者恩替卡韦进行治疗,剂量为0.5 mg/次,1次/d。替比夫定组给予患者替比夫定进行治疗,剂量为600 mg/次,1次/d。观察和比较患者实施治疗后的ALT复常率、病毒学应答率和HBe Ag转阴率,同时比较两组患者实施治疗前后的e GFR值水平。计量资料采用t检验,计数资料采用χ2检验。P<0.05为差异有统计学意义。结果恩替卡韦组ALT复常率、病毒学应答率和HBe Ag转阴率分别为51.28%、17.95%和5.13%,替比夫定组分别为56.41%、15.38%和5.13%。比较两组患者三项指标比较差异均无统计学意义(均P>0.05)。替比夫定组治疗前后的e GFR值分别为(81.23±8.34)、(91.34±9.43)ml/(min·1.73m2);恩替卡韦组治疗前后的e GFR值分别为(81.42±8.43)、(77.32±8.42)ml/(min·1.73m2)。治疗前两组患者的e GFR值比较差异无统计学意义(P>0.05);治疗后替比夫定组的e GFR值水平显著高于恩替卡韦组,对比差异有统计学意义(P<0.05)。结论在临床针对慢性乙型肝炎患者实施治疗的实践过程中,恩替卡韦与替比夫定的临床综合治疗效果相当,但是替比夫定对患者的肾脏功能起到更好的保护作用,是临床治疗慢性乙型肝炎的理想方式。
Objective To investigate the clinical effective treatment of chronic hepatitis B patients in order to provide a reference for the clinical diagnosis and treatment of chronic hepatitis B. Methods From December 2012 to December 2014, 78 patients with chronic hepatitis B admitted to our hospital from January 2012 to December 2014 were enrolled in this study. Patients were divided into entecavir group and telbivudine group according to the clinical treatment plan. Two groups All patients were 39 cases. Patients in the entecavir group were treated with entecavir at a dose of 0.5 mg once daily. Patients in the telbivudine group were treated with telbivudine at a dose of 600 mg once daily. Observed and compared ALT normalization rate, virological response rate and HBeAg negative conversion rate after treatment, and compared eGFR levels before and after treatment in both groups. Measurement data using t test, count data using χ2 test. P <0.05 for the difference was statistically significant. Results The rates of ALT, virological response and HBeAg negative rates were 51.28%, 17.95% and 5.13% in entecavir group and 56.41%, 15.38% and 5.13% in telbivudine group respectively. There was no significant difference in the three indexes between the two groups (all P> 0.05). The eGFR values before and after treatment with telbivudine were (81.23 ± 8.34) and (91.34 ± 9.43) ml / (min · 1.73m2), respectively. The e GFR values before and after treatment with telbivudine were (81.42 ± 8.43) and 77.32 ± 8.42) ml / (min · 1.73m 2). There was no significant difference in eGFR between the two groups before treatment (P> 0.05). After treatment, the level of e GFR in telbivudine group was significantly higher than that in entecavir group (P <0.05) . Conclusions The clinical efficacy of entecavir and telbivudine is equivalent in the clinical practice of treating patients with chronic hepatitis B. However, telbivudine has a better protective effect on the renal function of patients and is a clinical treatment Chronic hepatitis B is the ideal way.