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目的探讨恩替卡韦治疗ALT<2ULN慢性乙型肝炎的抗病毒效果。方法根据ALT水平,138例慢性乙型肝炎患者分为观察组(ALT<2 ULN,65例)和对照组(ALT≥2 ULN,73例),均给予恩替卡韦抗病毒治疗,比较两组患者治疗48、96周血清HBV DNA阴转率、HBeAg阴转率及血清转换率与HBsAg水平。结果治疗48周,观察组和对照组HBV DNA阴转率分别为73.85%和73.97%;治疗96周,观察组和对照组HBV DNA阴转率分别为93.85%和90.41%;两组HBV DNA阴转率均无统计学差异(P>0.05)。观察组和对照组治疗96周血清HBsAg水平均较治疗前下降(P<0.05),但两组血清HBsAg水平无统计学差异(P>0.05)。治疗48周,观察组HBeAg阴转率及血清转换率较对照组稍低(P>0.05);治疗96周,观察组HBeAg血清转换率低于对照组(P<0.05)。结论与ALT≥2ULN慢性乙型肝炎患者相比,恩替卡韦治疗ALT<2ULN慢性乙型肝炎患者有相似的抗病毒疗效,但HBeAg血清转换率较低,可能需要更长的疗程。
Objective To investigate the antiviral effect of entecavir in the treatment of chronic hepatitis B with ALT <2 ULN. Methods According to the level of ALT, 138 cases of chronic hepatitis B patients were divided into observation group (ALT <2 ULN, 65 cases) and control group (ALT≥2 ULN, 73 cases), were given entecavir antiviral therapy, compared two groups of patients treated 48,96 weeks serum HBV DNA negative rate, HBeAg negative conversion rate and serum conversion rate and HBsAg levels. Results After 48 weeks of treatment, the negative conversion rates of HBV DNA in the observation group and the control group were 73.85% and 73.97%, respectively. After 96 weeks of treatment, the negative conversion rates of HBV DNA in the observation group and the control group were 93.85% and 90.41% No significant difference in the rate of transfer (P> 0.05). The HBsAg levels of the observation group and the control group decreased 96 weeks after treatment (P <0.05), but there was no significant difference between the two groups in serum HBsAg level (P> 0.05). After 48 weeks of treatment, HBeAg negative conversion rate and seroconversion rate in the observation group were slightly lower than those in the control group (P> 0.05). After 96 weeks of treatment, HBeAg seroconversion rate in the observation group was lower than that in the control group (P <0.05). Conclusions Entecavir has a similar antiviral effect in patients with chronic hepatitis B ALT <2 ULN, but with a lower HBeAg seroconversion rate, which may require a longer course of treatment than patients with ALT ≥ 2 UL chronic hepatitis B.