聚乙二醇干扰素治疗慢性乙型肝炎的疗效及其对骨髓抑制的影响  

Efficacy of polyethylene glycol interferon on treatment of chronic hepatitis B and its impact on myelosuppression

作　　者：李广瑞[1] 邱素民[1] 杨桂艳[1] 

机构地区：[1]山东省金乡县人民医院药剂科,山东金乡272200

出　　处：《实用临床医药杂志》2013年第23期30-34,共5页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11321196)

摘　　要：目的探讨聚乙二醇干扰素(PEG-IFN-α)治疗慢性乙型肝炎(CHB)的疗效及其对骨髓抑制的影响。方法将198例CHB患者随机分为3组,A组给予PEG-IFNα-2a注射液;B组给予PEG-IFNα-2b注射液;C组给予普通IFNα。治疗前及治疗第12、24、48周时,分别检测3组患者的乙型肝炎病毒(HBV)DNA水平、乙肝5项定量,并以白细胞(WBC)、中性粒细胞(NEU)及血小板(PLT)水平判断骨髓抑制情况,同时观察治疗期间不良反应的发生情况。结果治疗12周时,3组HBV DNA水平均较治疗前显著下降,之后持续降低;A、B 2组治疗后各时间点HBV DNA水平显著低于C组,而2组间比较无显著差异。治疗24、48周时,A、B 2组HBV DNA阴转率显著高于C组;治疗48周时,A组乙肝表面抗原(HBsAg)阴转率显著高于C组,差异有统计学意义。治疗第12周时,3组WBC、PLT及NEU水平均显著低于治疗前,但组间比较无显著差异;治疗第24、48周时,A、B 2组间WBC、PLT及NEU水平无显著差异,而WBC及NEU水平均显著低于C组,且PLT水平在24周时亦显著低于C组。结论对于乙型肝炎e抗原(HBeAg)阳性的CHB患者,应用PEG-IFN-α制剂治疗的HBV DNA阴转率及HBsAg阴转率显著高于普通IFN-α,但骨髓抑制程度较后者明显。Objective To explore the efficacy of polyethylene glycol interferon a （PEG- IFN- ~） on the treatment of chronic hepatitis B （CHB） and its impact on myelosuppression. Meth- ods 198 patients with CI-IB were randomly divided into 3 groups. Group A was treated with PEG - IFNα- 2a injection, group B was treated with PEG - IFN α - 2b injection and group C was treated with common IFN α , Levels of hepatitis B virus （HBV） DNA and 5 sorts of quantization of hepatitis B were detected in all the groups at the time points of before treatment and 12, 24 and 48 weeks after start of treatment, and myelosuppression was judged by levels of white blood cells （WBC）, neutrophil （NEU） and platelets （PLT）. Meanwhile, the adverse reactions were observed during treatment. Results At the 12 weeks after start of treatment, level of HBV DNA in all the groups decreased significantly; levels of HBV DNA at each time point in group A and group B were signifieantly lower than group C, but there was no significant difference between group A and group B. At the 24 and 48 weeks after start of treatment, the negative conversion rate of HBV DNA in group A and group B were significantly higher than group C; at the 48 weeks after start of treatment, the negative conversion rate of HBsAg in group A was significantly higher than group C, and there was significant difference. At the 12 weeks after start of treatment, the levels of WBC, PLT and NEU decreased significantly in all the groups. At the 24 and 48 weeks after start of treatment,there were no significant differences of WBC, PLT and NEU between group A and group B, and levels of WBC and NEU in group A and group B were significantly lower than group C. Meanwhile, level of PLT at the 24 weeks after start of treatment in group A and group B were significantly lower than group C. Conclusion For CHB patients with positive manifestation of I-IBeAg, the negative conversion rates of HBV DNA and HBsAg by treatment of PEG- IFN - α were significantly higher than common IFN - α, b

关 键 词：慢性乙型肝炎 干扰素 聚乙二醇 骨髓抑制 

分 类 号：R512.6[医药卫生—内科学]