α-干扰素联合恩替卡韦治疗慢性乙型肝炎患者疗效Meta分析  

Efficacy of Interferon-α and entecavir in the treatment of patients with chronic hepatitis B:a meta-analysis

作　　者：李媚[1] 唐保东[1] 杨琛[2] 徐雅[1] 谭妙莲[3] 钟碧慧[1] 

机构地区：[1]中山大学附属第一医院东院消化内科,广州市510700 [2]中山大学附属第一医院体检中心,广州市510700 [3]中山大学附属第一医院预防保健科,广州市510700

出　　处：《实用肝脏病杂志》2014年第6期583-587,共5页Journal of Practical Hepatology

摘　　要：目的：比较干扰素-α联合恩替卡韦及干扰素单药治疗慢性乙型肝炎的疗效。方法查阅在PubMed、EMbase和Cochrane Library以及中国科技期刊全文数据库、万方、中国生物医学文献数据库2013年2月10日之前发表的文献，纳入所有符合条件的随机对照试验，应用Review Manager.5.1.0统计学软件进行分析。结果纳入合格文献4篇，包括259例慢性乙型肝炎患者，其中115例接受干扰素-α联合恩替卡韦治疗，144例为干扰素-α单药治疗。纳入文献漏斗图分析表明，研究以真值为中心呈对称性分布；在24 w时，联合治疗患者HBV DNA 阴转率为78.3%（90/115），显著高于单药治疗组[42.4%（61/144），RR=1.89，95% CI 1.52～2.36，P〈0.00001]；在48 w时，联合治疗组HBV DNA 阴转率为92.6%（88/95），显著高于单药治疗组[63.7%（79/124），RR =1.46，95% CI 1.26～1.70，P〈0.00001]；在24 w时，联合治疗组HBeAg血清转换率为37.4%（43/115），显著高于单药治疗组[27.1%（39/144），RR =1.46，95% CI 1.03～2.08，P=0.03]；在48 w时，联合治疗组HBeAg血清转换率为64.2%（61/95），显著高于INF-α单药治疗组[39.5%（49/124），RR=1.55，95% CI 1.19～2.01， P=0.001]；在24 w时，联合治疗组 ALT复常率为75.7%（87/115），显著高于单药治疗组[45.8%（66/144）， RR=1.71，95% CI 1.39～2.11，P〈0.00001）]；在48 w时，联合治疗组ALT 复常率为93.7%（89/95），显著高于单药治疗组[66.1%（82/124），RR=1.41，95% CI 1.23～1.61，P〈0.00001]。结论干扰素-α联合恩替卡韦治疗慢性乙型肝炎的疗效优于干扰素-α单药治疗。Objective To investigate the efficacy of combination therapy of interferon-α（IFN-α） plus entecavir （ETV） or IFN-α monotherapy in the treatment of patients with chronic hepatitis B （CHB）. Methods Articles published before February 10,2013 in database of PubMed,EMbase,Cochrane Library,China Biology Medicine disc,CNKI and WANFANG were searched. All eligible randomized controlled trials were included. Review Manager. 5.1.0 for Windows was used for Meta-analysis. Results Four articles that met the inclusion criteria were obtained,including a total of 259 patients with chronic hepatitis B,of which 115 received combination therapy and 144 received interferon-α alone. The funnel plot analysis showed that the research was distributed symmetrically with the true value as the center. HBV DNA negative rate in patients in combination therapy was higher than patients receiving monotherapy at 24 w and 48 w,and the differences were statistically significant [78.3%（90/115） vs. 42.4%（61/144）,RR=1.89,95% CI 1.52~2.36,P〈0.00001,and 92.6%（88/95）vs. 63.7%（79/124）,RR=1.46,95% CI 1.26~1.70,P〈0.00001];serum HBeAg conversion rate in patients in combination therapy group was significantly higher than patients receiving monotherapy at 24 w and 48 w [37.4%（43/115）vs. 27.1%（39/144）,RR=1.46,95% CI 1.03~2.08,P=0.03,and 64.2%（61/95）vs. 39.5%（49/124）,RR=1.55,95% CI 1.19~2.01,P=0.001];ALT normalization rate in patients receiving combination therapy was also significantly higher than in patients with monotherapy at 24 w and 48 w [75.7%（87/115）vs. 45.8%（66/144）,RR=1.71,95% CI 1.39~2.11,P〈0.00001,and 93.7%（89/95）vs. 66.1%（82/124）,RR=1.41,95% CI 1.23~1.61,P〈0.00001]. Conclusions Efficacy of interferon-α plus entecavir in the treatment of patients with CHB is superior to IFN-α monotherapy.

关 键 词：慢性乙型肝炎 干扰素-Α 恩替卡韦 治疗 Meta分析 

分 类 号：R512.62[医药卫生—内科学]