阿德福韦酯降低HBV-DNA载量后联合聚乙二醇干扰素α-2a治疗e抗原阳性慢性乙型肝炎的疗效初探  

Efficacy of adefovir dipivoxil combined with pegylated interferon α-2a after adefovir dipivoxil reducing HBV-DNA load in treatment of HBe Ag-positive patients with chronic hepatitis B

作　　者：安红杰[1] 何文艳[1] 徐金凤[1] 赵崇山[1] 

机构地区：[1]河北医科大学石油临床医学院感染科,廊坊市065000

出　　处：《广西医学》2015年第4期473-475,共3页Guangxi Medical Journal

基　　金：河北廊坊市科学技术研究与发展计划项目(2011013093)

摘　　要：目的观察阿德福韦酯(ADV)降低HBV-DNA载量后再联合聚乙二醇干扰素α-2a(peg IFNα-2a)治疗HBeAg阳性慢性乙型肝炎的疗效。方法 60例HBV-DNA≥1.0×107IU/ml的HBeAg阳性慢性乙型肝炎患者,随机分为两组:A组30例,治疗开始即口服ADV 10 mg,1次/d,并给予皮下注射peg IFNα-2a,180μg每周1次;B组30例,治疗开始即口服ADV 10 mg,1次/d,当1.0×103IU/ml<HBV-DNA≤1.0×104IU/ml时给予peg IFNα-2a 180μg,每周1次。两组疗程均48周。对比两组HBsAg阴转率及其血清学转换率、HBeAg血清转换率,HBV-DNA阴转率及ALT复常率的差异。结果治疗48周时,B组HBsAg阴转率为24.1%(7/29)稍高于A组的10.7%(3/28),B组HBsAg血清转换率为20.7%(6/29)稍高于A组的7.1%(2/28),但差异无统计学意义(P>0.05);B组患者HBeAg血清转换率为62.1%(18/29)显著高于A组患者的35.7%(10/28)(P<0.05);A、B两组患者ALT复常率、HBV-DNA阴转率,差异无统计学意义(P>0.05)。结论 ADV治疗HBV-DNA载量下降后联合peg IFNα-2a治疗能够提高慢性乙型肝炎患者的HBeAg血清转换率,对HBsAg阴转率及其血清转换率也有益。Objective To observe the efficacy of adefovir dipivoxil combined with pegylated interferon α-2a（pegIFNα-2a） after adefovir dipivoxil（ ADV） reducing HBV-DNA load in the treatment of HBeAg-positive patients with chronic hepatitis B.Methods Sixty HBeAg-positive chronic hepatitis B patients with HBV-DNA〉r =1.0 ×10^7 IU/ml were randomly divided into two groups.Thirty cases in Group A were orally given 10 mg of ADV once a day as well as subcutaneous injection of 180 μg of pegIFNα-2a once a week.Thirty cases in Group B were orally given 10 mg of ADV once a day at first,and then were given 180 μg of pegIFNα-2a once a week when HBV-DNA〉1.0 ×10^3 IU/ml and 〈1.0 ×10^4 IU/ml.The treatment lasted for 48 weeks in both groups.The negative rate of HBsAg, seroconversion rate of HBsAg,seroconversion rate of HBeAg,negative rate of HBV-DNA and recovery rate of ALT were compared between two groups.Results In the 48th week of treatment,the negative rate of HBsAg in Group B was slightly higher than that in Group A（24.1%（7/29） vs.10.7%（3/28））,the seroconversion rate of HBsAg in Group B was slightly higher than that in Group A（20.7%（6/29） vs.7.1%（2/28）;The negtive rate and seroconversion rate of HBsAg showed no significance between Group A and Group B（P〉0.05）;The seroconversion rate of HBeAg in Group B was significantly higher than that in Group A（62.1%（18/29） vs.35.7%（10/28）,P〈0.05）;And there were no significant differences in the recovery rate of ALT and negative rate of HBV-DNA between Group A and Group B （P〉0.05）.Conclusion The combination therapy of pegIFNα-2a and ADV following HBV DNA load has been inhibited by ADV might improve the seroconversion rate of HBeAg in patients with chronic hepatitic B and contribute to the negative rate and seroconversion rate of HBsAg.

关 键 词：慢性乙型肝炎 聚乙二醇干扰素Α-2A 阿德福韦酯 HBsAg HBeAg 血清转换率 

分 类 号：R512.62[医药卫生—内科学]