摘要
目的:评价国内恩替卡韦联合苦参素治疗HBeAg阳性慢性乙型肝炎(chronic hepatitis B,CHB)的疗效与安全性.方法:检索国内2005-2012年公开发表的恩替卡韦联合苦参素与单用恩替卡韦比较治疗HBeAg阳性CHB的随机对照试验,以比值比(odds ratio,OR)为效应量进行异质性检验和统计量合并分析.采用Cochrane协作网提供的RevMan5.2软件进行荟萃分析.结果:经筛选共纳入10项随机对照试验,合计765例患者,其中治疗组382例,对照组383例.荟萃分析结果显示,在治疗结束时,治疗组血清HBV-DNA转阴率高于对照组(81.3%vs66.5%,OR=2.49,95%CI:1.70-3.66),血清HBeAg转阴率高于对照组(52.3%vs26.5%,OR=3.27,95%CI:2.23-4.80),丙氨酸转氨酶复常率高于对照组(88.4%vs68.0%,OR=3.62,95%CI:2.43-5.39),HBeAg血清转换率高于对照组(45.3%vs23.2%,OR=2.98,95%CI:2.00-4.44),差异均有统计学意义(P<0.01).结论:恩替卡韦联合苦参素对HBeAg阳性C H B的抗病毒疗效显著优于恩替卡韦单用,具有较好的安全性和耐受性.
AIM： To compare the efficacy of entecavirmatrine combination therapy versus entecavir monotherapy in the management of HBeAg- positive chronic hepatitis B in China. METHODS： A computer-based search of relevant randomized controlled trials was performed. The pooled odds ratio and 95% confidence interval （CI） of outcome indicators were used to measure the magnitude of the efficacy. Meta-analysis was carried out using RevMan 5.2 software.RESULTS： Ten trials including 765 patientswere identified. The combination therapy was remarkably more effective than monotherapy at the end of the treatment in terms of rates of HBV-DNA negative conversion （81.3% vs 66.5%, OR = 2.49, 95%CI： 1.70-3.66）, HBeAg loss （52.3% vs 26.5%, OR = 3.27, 95%Ch 2.23-4.80）, ALT normalization （88.4% vs 68.0%, OR = 3.62, 95%CI： 2.43-5.39） and HBeAg seroconversion （45.3% vs 23.2%, OR = 2.98, 95%CI： 2.00-4.44）. CONCLUSION： Entecavir-matrine combination therapy achieves superior efficacy with no increase in adverse effects as compared with entecavir monotherapy in the management of HBeAg-positive hepatitis B.
出处
《世界华人消化杂志》
CAS
北大核心
2013年第15期1432-1436,共5页
World Chinese Journal of Digestology
