聚乙二醇干扰素α-2a联合阿德福韦酯治疗慢性乙型肝炎的Meta分析  

Peginterferon α-2a and adefovir dipivoxil combination therapy for chronic hepatitis B: a Meta-analysis

作　　者：吴发玲[1] 丁洋[2] 窦晓光[2] 

机构地区：[1]中国医科大学七年制临床医学,沈阳110001 [2]中国医科大学附属盛京医院感染科,沈阳110004

出　　处：《实用药物与临床》2012年第1期4-10,共7页Practical Pharmacy and Clinical Remedies

基　　金：国家自然科学基金项目(30972612);辽宁省科学技术计划重大;重点项目(2009225010-7);中华医学会肝炎防治基金会光辉基金(GHF2010203)

摘　　要：慢性乙型肝炎由乙型肝炎病毒感染所致,首选干扰素(IFN)或核苷(酸)类似物(NUC)单药抗病毒治疗,但IFN单药治疗往往应答率低,NUC长期用药易发生病毒变异,产生耐药,影响疗效,因此提倡联合治疗。目前,联合治疗分为初始联合及治疗中联合,联合药物有NUC联合NUC,或IFN联合NUC。临床试验发现,聚乙二醇干扰素α-2a(Peg-IFNα-2a)联合拉米夫定短期疗效不佳,联合替比夫定可能出现周围神经病变,因此,寻找新的联合治疗方案十分必要。笔者查阅Peg-IFNα-2a联合阿德福韦酯(ADV)治疗CHB的临床试验发现,其疗效和安全性各方评价不一。本文就Peg-IFNα-2a联合ADV治疗CHB有效性和安全性的随机对照试验进行Meta分析,以期为临床用药提供参考。Chronic hepatitis B is caused by hepatitis B virus （HBV）. Antiviral therapy is the key point of delaying the development of the disease. Naive monotherapy with either interferon （IFN） or nucleotide analogue （ NUC ） failed to achieve sustained remission because of the poor response, YMDD mutation and drug resistance after long-term use, Recently, the notion of combination therapy of IFN and NUC during naive-treatment or on-treatment has been proposed. The clinical trial shows no different short-term efficacy between the combination therapy of peg-IFN α-2a with lamivudine and the monotherapy of peg-IFN α-2a alone. The combination of Peg-IFN α-2a with telbivudine possibly resulted in peripheral neuropathy. It is necessary to choose different drugs for combination therapy in different stages of treatment. Based on the clinical trials of the combination therapy of peg-IFN α-2a and adefovir dipivoxil（ADV） ,controversial results of the efficacy and safety are showed. We performed the meta-analysis to evaluate the efficacy and safety of large sample.

关 键 词：聚乙二醇干扰素Α-2A 阿德福韦酯 慢性乙型肝炎 联合治疗 META分析 

分 类 号：R512.62[医药卫生—内科学]