拉米夫定、α-2b干扰素治疗HBeAg(＋)慢性乙型肝炎疗效与基因型相关性研究  

The relationship of hepatitis B virus genotypes and efficacy of lamivudine and interferon alpha 2b in the treatment of HBeAg-positive chronic hepatitis B

作　　者：李俊[1] 陈新月[2] 赵鸿[1] 于岩岩[1] 斯崇文[1] 韩忠厚[3] 张文谨[4] 陈宇萍[5] 陈勇[6] 王贵强[1] 于敏[1] 公维波[1] 徐京杭[1] 王军[1] 蔺小红[1] 李雪迎[7] 

机构地区：[1]北京大学第一医院感染疾病科,北京100034 [2]北京市佑安医院,北京100069 [3]秦皇岛市第三人民医院,河北秦皇岛066001 [4]中国人民解放军302医院,北京100039 [5]保定市传染病医院,河北保定071000 [6]淮安市第四人民医院,江苏淮阴223300 [7]北京大学第一医院医学统计室,北京100034

出　　处：《临床肝胆病杂志》2008年第3期169-171,共3页Journal of Clinical Hepatology

基　　金：北京市科委病毒性肝炎重大项目(H020920020690);北京大学211工程循证医学课题(91000-246156054)

摘　　要：目的探索乙型肝炎病毒(HBV)基因型与拉米夫定、α-2b干扰素序贯治疗及单独予拉米夫定、α-2b干扰素治疗HBeAg阳性慢性乙型肝炎患者的疗效的相关性。方法HBeAg阳性慢乙肝患者,来自北京等四城市。分别拉米夫定、干扰素序贯治疗48周、拉米夫定48周或干扰素24周。停药后随访24周。评价HBV基因型与抗病毒治疗应答的关系。PCR-RFLP方法检测HBV基因型、基因亚型。结果225例患者中C基因型184例,其中C2亚型165例;B基因型41例,均为Ba亚型。治疗结束、随访结束时,各治疗组B型与C型间病毒学应答、血清学应答及完全应答率差异均无显著性。结论该四城市HBeAg阳性慢乙肝患者HBV基因型以B型和C型为主,亚型以Ba和C2亚型为主。治疗结束、随访结束时,各治疗组B型与C型间疗效无差异。Objective To study the relationship of hepatitis B virus （HBV） genotypes and the response to antiviral therapy of HBeAg - positive chronic hepatitis B （CHB） patients. Methods 225 CHB patients from four cities were treated by three ways, sequential therapy with lamivudine and interferon ct -2b （IFN） for 48 weeks, lamivudine monothempy for 48 weeks or IFN for 24 weeks. The relationship between HBV genotypes and antiviral responses was investigated. PCR - RFLP was used to typing HBV genotypes and subgenotypes. Results All patients had single genotype, B or C. Every patient with genotype B belonged to subgroup Ba. Genotype C2 was the predominant subgroup in genotypo C. There was no significant difference between genotype B and C in antiviral responses in each group at the end of therapy and follow - up. Conclusion Genotypes B and C, subgroups Ba and C2 were predominant in HBeAg - positive CHB patients in these four cities. The antiviral efficacy between genotype B and C in each group had no difference.

关 键 词：拉米夫定 Α-2B干扰素 乙型肝炎病毒 基因型 

分 类 号：R512.6[医药卫生—内科学]