拉米夫定在IFN-α经治HBeAg阳性慢性乙肝患者中的疗效观察  

Evaluation of Lamivudine Efficacy on Previous Interferon-α Therapy in Patients with HBeAg-positive Chronic Hepatitis B

作　　者：王海燕[1] 朱传武[1] 李明[1] 罗湘蓉[1] 钱峰[1] 沈秀娟[1] 朱翔[1] 张雪华[1] 朱伟[1] 王佩[1] 

机构地区：[1]苏州市第五人民医院,江苏苏州215007

出　　处：《抗感染药学》2013年第4期316-319,共4页Anti-infection Pharmacy

摘　　要：目的:探讨拉米夫定(LMV)治疗干扰素(IFN-α)经治HBeAg阳性慢性乙肝患者(以下简称CHB)的疗效。方法:回顾性收集96例IFN-α经治CHB(IFN-α经治组)接受LMV治疗2—3年生化学、乙肝病毒血清学和病毒学资料,并以同期102例LMV初治患者(LMV初治组)作为对照组,比较既往INF-α治疗对后续LMV疗效的影响。结果:IFN-α经治组在12,24和36月的累积联合应答率分别为26.0%,46.9%和66.0%,而LMV初治组分别为12.8%,25.5%和44.9%,两组之间比较,其差异有统计学意义(P<0.01);在治疗24和36月时,LMV初治组累积病毒学突破率分别为13.7%和26.1%,而IFN-α经治组分别为7.3%和9.6%,两组间比较,其差异有统计学意义(P<0.01);经多因素分析显示IFN-α经治组与3年LMV治疗的联合应答有密切相关性(P<0.01),与HBV-DNA突破也有密切相关性(P<0.05)。结论:LMV对IFN-α经治组HBeAg阳性CHB的抗病毒疗效均显著优于LMV初治组患者,提示既往IFN-α治疗有利于提高LMV的抗病毒应答。Objective： To investigate the influence of previous IFN-α treatment on lamivudine efficacy in patients with HBeAg posotive chronic hepatitis B. Methods： The biochemical,HBV serological and virological data were retrospectively collected from the patients who received lamivudine therapy for 2 to 3 years. Of them, 96 patients were previously treated with IFN-α（IFN-experienced group）,and 102 patients were never administered any antivial agents before lamivudine initiation（LMV-naive group）. Results： The data showed that the cumulative rates of combined response at 12, 24 and 36 months of treatment were 26.0%, 46.9% and 66.0% respectively in IFN-experienced group, while those were 12.8%, 25.5% and 44.9% respectively in LMVnaive group. There was significant difference between the two groups（P0.01）; the cumulative rates of HBV DNA breakthrough at 24 and 36 months were 13.7% and 26.1% respectively in LMV-na ve group, which were remarkably higher than 7.3% and 9.6% respectively in IFN-experienced group（P0.01）. The multivariate analyses revealed that the previous IFN-α treatment was significantly associated with the combined response（P0.01） and also with HBV DNA breakthrough（P0.05） during treatment. Conclusions： The efficacy of lamivudine therapy in patients previously treated with IFN-α was remarkably superior to control patients. All these which indicated that the previous IFN-α treatment was a favourable factor associated with improved lamivudine efficacy.

关 键 词：慢性乙型肝炎(CHB) HBEAG阳性 抗病毒疗法 干扰素(IFN-α) 拉米夫定(LMV) 

分 类 号：R978.7[医药卫生—药品]