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[恩替卡韦用于重庆地区拉米夫定治疗失败的慢性乙型肝炎患者的五年试验]

[Five years trial of entecavir for chronic hepatitis B patients failed with lamivudine therapy in the Chongqing area].

作者信息

LI Hong, WANG Zhi-yi, ZHANG Da-zhi, SHI Xiao-feng, ZHOU Zhi, REN Hong

机构信息

Department of Infectious Diseases, Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2009 May;17(5):338-41.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of five-year trail of entecavir for chronic hepatitis B patients failed with lamivudine therapy in the Chongqing area.

METHODS

32 patients failed with lamivudine therapy were enrolled in this study. In the double-blind phase, patients were randomly divided into entecavir 1.0 mg/d group (n = 28) and placebo group(n = 4) for 12 weeks. In the open-lable phase, patients received ETV 1.0 mg/d for 240 weeks. HBV DNA level, liver function, HBV serology were observed.

RESULTS

The mean reduction in HBV DNA level at week 12 was 4.05 log10 copies/ml in ETV group, and 0.08 log10 copies/ml in placebo group (P less than 0.05). The mean of HBV DNA level after 240 weeks of ETV treatment was decreased to 2.58 log10 copies/ml. The proportion of patients with HBV DNA less than 3 log10 copies/ml was 0, 6.25%, 15.6% , 50%, and 57.14% at 0, 8, 24, 96 and 240 weeks respectivfely. There were 2 patients with HBsAg seroconversion and 4 patients with HBeAg seroconversion at the end of the study. The ALT level returned to normal at week 12 and remained normal throughout the following 240 weeks. One patient had a severe adverse event during the trail.

CONCLUSION

Entecavir is effective and safe for the chronic hepatitis B patients failed with lamivudine therapy.

摘要

目的

评估恩替卡韦对重庆地区拉米夫定治疗失败的慢性乙型肝炎患者进行五年治疗的疗效和安全性。

方法

本研究纳入32例拉米夫定治疗失败的患者。在双盲阶段,患者被随机分为恩替卡韦1.0mg/d组(n = 28)和安慰剂组(n = 4),治疗12周。在开放标签阶段,患者接受恩替卡韦1.0mg/d治疗240周。观察乙肝病毒脱氧核糖核酸(HBV DNA)水平、肝功能、乙肝血清学指标。

结果

恩替卡韦组第12周时HBV DNA水平平均下降4.05 log10拷贝/ml,安慰剂组为0.08 log10拷贝/ml(P<0.05)。恩替卡韦治疗240周后HBV DNA水平平均降至2.58 log10拷贝/ml。HBV DNA低于3 log10拷贝/ml的患者比例在第0、8、24、96和240周时分别为0、6.25%、15.6%、50%和57.14%。研究结束时,有2例患者乙肝表面抗原(HBsAg)血清学转换,4例患者乙肝e抗原(HBeAg)血清学转换。谷丙转氨酶(ALT)水平在第12周恢复正常,并在随后的240周内一直保持正常。试验期间有1例患者发生严重不良事件。

结论

恩替卡韦对拉米夫定治疗失败的慢性乙型肝炎患者有效且安全。

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