| 蒋坤,刘景瑞,叶飞翔,等.替诺福韦酯与恩替卡韦治疗慢性乙型病毒性肝炎的疗效及对 TNF-α、IL-10水平的影响[J].安徽医药,2025,29(10):2048-2052. |
| 替诺福韦酯与恩替卡韦治疗慢性乙型病毒性肝炎的疗效及对 TNF-α、IL-10水平的影响 |
| Curative effect of tenofovir disoproxil and entecavir on chronic viral hepatitis B and their influences on TNF-α and IL-10 |
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| DOI：10.3969/j.issn.1009-6469.2025.10.027 |
| 中文关键词: 乙型肝炎，慢性 替诺福韦酯 恩替卡韦 乙型肝炎病毒 肿瘤坏死因子 α 白细胞介素 -10 |
| 英文关键词: Hepatitis B,chronic Tenofovir disoproxil Entecavir Hepatitis B virus Tumor necrosis factor α Interleukin-10 |
| 基金项目:军队后勤自主科研项目( 20221102) |
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| 中文摘要: |
| 目的探讨替诺福韦酯与恩替卡韦治疗慢性乙型病毒性肝炎(CHB)的疗效及对肿瘤坏死因子 α(TNF-α)、白细胞介素 -10(IL-10)水平的影响。方法采用前瞻性研究方法选取 2021年 12月至 2023年 12月在淮安市四人民医院收治的 82例 CHB病人，据随机数字表法将其分为替诺福韦酯组( 41例)和恩替卡韦组( 41例)两组病人均给予阿德福韦酯基础治疗 1年。替诺福韦酯组在阿德福韦酯基础治疗 1年后给予替诺福韦酯治疗 3个月，恩替卡韦，组在阿德福韦酯基础治疗 1年后给予恩替卡韦治疗 3个月。比较两组病人临床疗效，不良反应发生情况；比较治疗前和治疗 2周、 1个月和 3个月后病人血清丙氨酸转氨酶(ALT)、总胆红素( TBil)、天冬氨酸转氨酶( AST)、 Ⅲ型前胶质肽( PCⅢ)、透明质酸( HA)、 TNF-α、IL-10和乙肝病毒( HBV)-DNA水平。结果替诺福韦酯组总有效率为 92.68%，显著高于恩替卡韦组的 75.61%(P<0.05)。治疗 2周、 1个月和 3个月后，替诺福韦酯组的 ALT［( 47.53±8.47)U/L、(37.64±7.82)U/L、(24.93±6.75)U/L］、 TBil［( 38.61±10.02)μmol/L、(30.76±8.14)μmol/L(23.64±7.39)μmol/L］、 AST［( 32.41±3.58)U/L、(26.79±3.25)U/L、(22.34±3.16)U/L］、 PCⅢ、HA、HBV-DNA、TNF-α和 IL-10均低于恩替卡韦组的 ALT［(51.36±8.52)U/L、(42.73±7.73)U/L、(31.08±6.79)U/L］，TBil［(40.58±10.75)μmol/L、(35.34±8.13)μmol/L、(30.16±7.42)μmol/L］，AST［(34.08±3.63)U/L、(29.74±3.48)U/L、(26.57±3.25)U/L］，PCⅢ［(37.65±3.48)μg/L、(31.83±3.26)μg/L、(24.09±3.11)μg/L］，HA，HBV-DNA，TNF-α和 IL-10，均差异有统计学意义( P<0.05)。结论在阿德福韦酯基础上给予 CHB病人替诺福韦酯治疗的效果比恩替卡韦作用更显著，两者安全性相当。 |
| 英文摘要: |
| Objective To explore the curative effect of tenofovir disoproxil and entecavir on chronic viral hepatitis B (CHB) and theirinfluences on tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10).Methods In the prospective study, 82 patients with CHBadmitted to Huai'an Fourth People's Hospital from December 2021 and December 2023 were enrolled. According to random number ta-ble method, they were divided into tenofovir disoproxil group (41 cases) and entecavir group (41 cases). On basis of basic treatment withadefovir dipivoxil for 1 year, tenofovir dipivoxil group was treated with tenofovir dipivoxil, while entecavir group was treated with enteca-vir for 3 months. The clinical curative effect and occurrence of adverse reactions, levels of serum alanine aminotransferase (ALT), totalbilirubin (TBil), aspartate aminotransferase (AST), type Ⅲ proglial peptide (PCⅢ), hyaluronic acid (HA), TNF-α, IL-10 and hepatitis B virus (HBV)-DNA before treatment and after 2 weeks, 1 month and 3 months of treatment were compared between the two groups.Re. sults The total response rate in tenofovir disoproxil group was significantly higher than that in entecavir group (92.68% vs. 75.61%, P < 0.05). After 2 weeks, 1 month and 3 months of treatment, levels of ALT [(47.53±8.47) U/L, (37.64±7.82) U/L, (24.93±6.75) U/L],TBil [(38.61±10.02) μmol/L, (30.76±8.14) μmol/L, (23.64±7.39) μmol/L], AST [(32.41±3.58) U/L, (26.79±3.25) U/L, (22.34±3.16) U/L], PCIII, HA, HBV-DNA, TNF-α and IL-10 in tenofovir disoproxil group were lower than those in entecavir group [ALT [(51.36±8.52) U/L, (42.73±7.73) U/L, (31.08±6.79) U/L], TBil [(40.58±10.75) μmol/L, (35.34±8.13) μmol/L, (30.16±7.42) μmol/L], AST [(34.08±3.63) U/L, (29.74±3.48) U/L, (26.57±3.25) U/L], PCⅢ [(37.65±3.48) μg/L, (31.83±3.26) μg/L, (24.09±3.11) μg/L], HA, HBV-DNA, TNF-α and IL-10], and the differences were statistically significant (P < 0.05).Conclusion The effect of tenofovir dipivoxil in CHBpatients based on adefovir dipivoxil is more significant than that of entecavir, and the safety of the two is comparable. |
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