替诺福韦酯和恩替卡韦治疗乙型肝炎的效果和用药成本比较
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篇名: 替诺福韦酯和恩替卡韦治疗乙型肝炎的效果和用药成本比较
TITLE:
摘要: 目的:比较替诺福韦酯和恩替卡韦治疗乙型肝炎的效果和用药成本。方法:选取2015年9月-2016年9月我院收治的300例乙型肝炎病毒(HBV)感染患者,随机分为替诺福韦酯组和恩替卡韦组,每组150例。替诺福韦酯组患者口服富马酸替诺福韦二吡呋酯片300 mg,每日1次;恩替卡韦组患者口服恩替卡韦片0.5 mg,每日1次,均连续用药48周。比较两组患者给药前和给药24、48周后HBV脱氧核糖核酸(HBV-DNA)水平、HBV-DNA阴转率、丙氨酸转氨酶(ALT)水平、ALT复常率,以及给药48周后的用药成本-效果比和不良反应。结果:两组患者给药前HBV-DNA水平,给药前和给药24、48周ALT水平和ALT复常率比较差异均无统计学意义(P>0.05)。与恩替卡韦组比较,替诺福韦酯组患者给药24周、48周后HBV-DNA水平均明显降低(P<0.05);替诺福韦酯组患者给药24周后的HBV-DNA阴转率略高,但差异无统计学意义(P>0.05),给药48周后的HBV-DNA阴转率明显升高(P<0.05)。替诺福韦酯组的HBV-DNA阴转及ALT复常用药成本-效果比均优于恩替卡韦组(P<0.05),总不良反应发生率低于恩替卡韦组(P<0.05)。结论:替诺福韦酯可有效治疗HBV,其效果和用药成本均优于恩替卡韦。
ABSTRACT: OBJECTIVE: To compare the effects and medication cost of tenofovir disoproxil and entecavir in the treatment of hepatitis B. METHODS: A total of 300 patients with HBV infection selected from our hospital during Sept. 2015-Sept. 2016 were randomly divided into tenofovir disoproxil group and entecavir group, with 150 cases in each group. Tenofovir disoproxil group was given Tenofovir disoproxil fumarate tablet 300 mg orally, qd. Entecavir group was given Entecavir tablet 0.5 mg orally, qd, for consecutive 48 weeks. HBV-DNA level, negative conversion rate of HBV-DNA, ALT level and ALT normalization rate were compared between 2 groups before treatment, after 24, 48 weeks of treatment. The medication cost-effectiveness ratio and ADR were compared between 2 groups after 48 weeks of treatment. RESULTS: There were no statistical significances in the level of HBV-DNA between 2 groups before treatment, the level of ALT and ALT normalization rate before treatment, after 24, 48 weeks of treatment (P>0.05). Compared with entecavir group, the level of HBV-DNA in tenofovir disoproxil group after 24, 48 weeks of treatment was decreased significantly (P<0.05); the negative rate of HBV-DNA in tenofovir group was slightly higher after 24 weeks of treatment, without statistical significance (P>0.05); the negative rate of HBV-DNA was slightly increased after 48 weeks of treatment (P<0.05). Negative conversion rate of HBV-DNA and medication cost-effectiveness ratio of ALT normalization in tenofovir disoproxil group were better than entecavir group (P<0.05). The incidence of ADR in tenofovir dipivoxil group was lower than entecavir group (P<0.05). CONCLUSIONS: Tenofovir dipivoxil can effectively treat HBV, and its effects and medication cost are both better than entecavir.
期刊: 2018年第29卷第3期
作者: 陈长洋,林志群,李小瑜
AUTHORS: CHEN Changyang,LIN Zhiqun,LI Xiaoyu
关键字: 替诺福韦酯;恩替卡韦;乙型肝炎病毒;谷丙转氨酶;用药成本
KEYWORDS: Tenofovir disoproxil; Entecavir; Hepatitis B virus; Alanine transaminase; Medication cost
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