摘要
目的探讨恩替卡韦与阿德福韦酯对核苷初治HBeAg阳性慢性乙型肝炎患者的疗效。方法检索2000年1月—2010年5月公开发表的有关恩替卡韦(剂量0.5mg/d)与阿德福韦酯(剂量10 mg/d)治疗HBeAg阳性的核苷初治的慢性乙型肝炎(疗程≥48周)的随机对照临床研究。采用x^2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。疗效判定指标包括血清HBV DNA检测不到(阴转)、血清ALT复常、血清HBeAg阴转、抗-HBe血清转换和药物不良反应。结果最终纳入1篇英文文献,3篇中文文献,纳入文献的总体质量较高(Jadad评分2～4分)。Meta分析结果显示,恩替卡韦治疗组血清HBV DNA阴转率、血清ALT复常率高于阿德福韦酯组(均P<0.01),而2组血清HBeAg转阴率、血清抗-HBe转换率和不良反应发生率的差异无统计学意义(均P>0.05)。结论恩替卡韦在降低患者血清HBV DNA载量和促使ALT回复正常水平方面优于阿德福韦酯,但在血清HBeAg转阴率、血清抗-HBe转换率及不良反应方面两者相似。
Objective To evaluate the therapeutic efficacy between entecavir and adefovir dipivoxil in chronic hepatitis B patients with HBeAg positive.Methods Reviewed the Chinese and English articles（randomized controlled clinical trials） about comparison of efficacy between entecavir and adefovir dipivoxil in chronic hepatitis B patients with HBeAg positive, which searched from January 2000 to May 2010.The dosages of entecavir and adefovir dipivoxil were respectively 0.5mg/d and 10mg/d,and treatment course lasted over 48 weeks.Heterogeneity was examined by Chi-square test,the relative risk was calculated and forest graph was drawn.The evaluated index contained undetected serum HBV DNA,serum ALT normalization, HBeAg loss,anti-HBe seroconversion and adverse effect.Results One English article and three Chinese articles were included,which were fit well for the study（Jadad score 2～4）.Meta analysis showed that the rates of undetected serum HBV DNA and serum ALT normalization in the group of entecavir were higher than those in the group of adefovir dipivoxil（all P0.01）,while there were no statistic significances on the rates of HBeAg loss,anti-HBe seroconversion and adverse effect in the both groups（all P0.05）.Conclusion Based on our Meta analysis results,the entecavir was superior to adefovir dipivoxil in decreasing serum HBV DNA and normalizing serum ALT,however,as for the rates of HBeAg seroconversion,anti-HBe seroconversion and side effects,the efficacies of the two drugs were similar.
出处
《疑难病杂志》
CAS
2011年第1期23-26,共4页
Chinese Journal of Difficult and Complicated Cases
关键词
乙型肝炎
慢性
核苷类似物
HBEAG阳性
核苷初治
Hepatitis B
chronic
Nucleoside and nucleotide analogues
HBeAg positive
Nucleotide naive
