替比夫定与干扰素α2b治疗HBeAg阳性慢性乙型肝炎疗效比较  

Comparative Effect of Telbivudine and Interferon α2b in HBeAg positive Chronic Hepatitis B

作　　者：吴燕京[1] 金瑞[1] 张世斌[1] 

机构地区：[1]首都医科大学附属北京佑安医院消化中心,北京100069

出　　处：《临床消化病杂志》2013年第2期88-90,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：目的比较替比夫定与重组人干扰素α2b治疗HBeAg阳性慢性乙型肝炎的临床疗效。方法对220例门诊治疗的HBeAg阳性慢性乙型肝炎患者的临床资料进行回顾性分析。替比夫定治疗组104例及干扰素α2b组116例,治疗48周,观察两组患者血清HBVDNA水平、HBV血清学标志物、肝脏生化指标的变化,同时监测不良反应的发生。结果治疗48周,重组人干扰素α2b组的HBeAg转换率优于替比夫定组,差异有统计学意义(P<0.05)。替比夫定治疗12周及24周,HBVDNA转阴率优于重组人干扰素α2b组,差异有统计学意义(P<0.05)。替比夫定组不良事件的发生率与重组人干扰素α2b组比较无明显差异,但血清肌酸激酶(CK)升高的病例高于重组人干扰素α2b组。结论替比夫定在迅速持续抑制HBV的复制方面优于重组人干扰素α2b,而在HBeAg阴转率与重组人干扰素α2b接近,提示替比夫定除强效抑制乙型肝炎病毒(HBV)复制外,同时存在免疫调节作用,不良反应较少,可用于慢性乙型肝炎的长期治疗。在治疗中应注意监测CK水平变化。Objective To compare the clinical effect of the telbivudine and the recombinant human interferon α2b in HBeAg-positive chronic hepatitis B patients. Methods The 220 cases of HBeAg-positive chronic hepatitis B outpatients were analyzed retrospectively,for telbivudine treatment group of 104 cases and recombinant human interferon α2b group of 116 ca- ses,after 48 weeks treatment. To observe the patients serum HBV DNA level,HBV serological markers, and the liver biochemi- cal indicators, at the same time monitoring the occurrence of adverse reactions. Results After 48 weeks of treatment, in recom- binant human interferon α2b group, the HBeAg conversion rate is better than the telbivudine group, the difference had statistical significance （ P 〈 0.05 ）. When 12 weeks and 24 weeks, HBV DNA negative rate in telbivudine group is superior to recombinant human interferon α2b group,the difference had statistical significance （P 〈 0.05）. The incidence of adverse in telbivudine group and recombinant human interferon α2b group is no obvious difference, but in telbivudine group, the rate of increased ser- um creatine kinase （CK） is higher than the recombinant human interferon α2b group. Conclusion Telbivudine is superior to recombinant human interferon oL2b in rapid and continuous inhibit of HBV replication, and the negative rate of HBeAg is close to recombinant human interferon α2b, suggesting that telbivudine can potently inhibit HBV replication, at same time have the immune regulation effects, and there is no adverse effect found during the therapy, so telbivudine can be used for long-term treatment of chronic hepatitis B, in the treatment should be paid attention to monitor the CK level.

关 键 词：慢性乙型肝炎 HBEAG 替比夫定 干扰素Α2B 肌酸激酶 

分 类 号：R512.62[医药卫生—内科学]