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目的比较恩替卡韦与阿德福韦酯治疗拉米夫定耐药慢性乙型肝炎患者的效果。方法检索2010年6月以前公开发表的有关恩替卡韦(剂量1mg/d)与阿德福韦酯(剂量10mg/d)治疗拉米夫定耐药慢性乙型肝炎患者(疗程≥48周)的随机对照临床研究。采用χ2检验分析研究间的异质性,以相对危险度为疗效分析统计量进行合并分析并绘制森林图。疗效判定指标为血清HBVDNA检测不到(阴转)。结果 Meta分析结果显示,阿德福韦酯与恩替卡韦对拉米夫定耐药株的疗效差异有统计学意义(Z=2.26,P=0.02),相对危险度的95%置信区间为0.51～0.95。结论恩替卡韦(1mg/d)治疗拉米夫定耐药患者的48周疗效(血清HBVDNA阴转率)好于阿德福韦酯(10mg/d)。
Objective To compare the efficacy of entecavir and adefovir dipivoxil in the treatment of lamivudine-resistant chronic hepatitis B patients. Methods A randomized controlled clinical trial was conducted to evaluate the efficacy of entecavir (dose 1 mg / d) and adefovir dipivoxil (dose 10 mg / d) published before June 2010 in the treatment of patients with lamivudine-resistant chronic hepatitis B (≥48 weeks) Control clinical study. Chi-square test was used to analyze the heterogeneity of the study, and the relative risk was analyzed for the efficacy analysis statistics and the forest diagram was drawn. Efficacy indicators for the detection of serum HBVDNA underaged (negative). Results Meta analysis showed that there was significant difference between adefovir dipivoxil and entecavir in lamivudine resistant strains (Z = 2.26, P = 0.02). The 95% confidence interval of relative risk was 0.51 ~ 0.95 . Conclusions The efficacy of entecavir (1 mg / d) for 48 weeks in patients with lamivudine resistance (serum HBVDNA negative rate) is better than that of adefovir dipivoxil (10 mg / d).