延长聚乙二醇干扰素α-2a疗程对慢性乙型肝炎患者疗效的影响  

Impact of extended peginterferon alfa-2a therapy on the curative effect of patients with HBe Ag-positive chronic hepatitis B

作　　者：李正军[1] 王争艳 金钊 严兴耘 

机构地区：[1]甘肃省中医院,兰州市730050 [2]甘肃省兰州石化总医院,兰州市730060

出　　处：《内科》2015年第4期442-445,共4页Internal Medicine

摘　　要：目的评估延长聚乙二醇干扰素α-2a疗程对慢性乙型肝炎患者疗效及安全性的影响。方法 40例HBe Ag阳性慢性乙型肝炎患者均接受聚乙二醇干扰素α-2a治疗,其中常规治疗组(20例)患者治疗48周,延长治疗组(20例)患者治疗72周。所有患者治疗结束后随访48周。观察治疗结束时及治疗结束后随访24、48周时两组患者的HBs Ag清除率、HBe Ag血清学转换率、HBV-DNA阴转及ALT复常情况。观察两组患者治疗全程中所有不良反应发生情况。结果治疗结束后随访24、48周时,延长疗程组患者的HBe Ag血清学转换率均高于常规疗程组(P<0.05),延长疗程组患者的HBV-DNA阴转率也明显高于常规治疗组(P<0.05)。延长疗程具有和标准疗程相同的安全性。结论相对于标准疗程,延长治疗疗程使HBe Ag阳性的CHB患者在治疗结束后维持了相对持久的病毒学应答,延长疗程可能是提高临床疗效的一种有希望的治疗策略。Objective To evaluate the efficacy and safety of extended durations of PEG-IFNa-2a monotherapy in treatment of patients with chronic hepatitis B. Methods 40 patients with chronic hepatitis B were divided into extended therapy group （72 weeks treatment） and standard therapy group（48 weeks treatment）, both group were treated with peginterferonA-2a monothera- py and were followed up until 48 weeks post-treatment. Serum ALT, HBsAg clearance, HBeAg seroconversion and HBV-DNA levels of the two groups were determined at baseline, the end of treatment, and at 24 and 48 weeks post-treatment. All adverse reactions in treatment duration were observed. Results At 24 and 48 weeks post-treatment, the rate of HBeAg seroconversion in the extended therapy group was significantly higher than that in the standard therapy group（P 〈 0.05 ）, HBV-DNA negativity rate in the extended therapy group was also significantly higher than that in the standard therapy group（P 〈0.05 ）. Extended therapy group had the same safety as standard therapy group. Conclusions Compare with standard therapy, extended durations of PEG-IFNa-2a may be a promising strategy to improved clinical efficacy which safely achieved higher rates of sustainable HBeAg seroconversion and HBV-DNA suppression in patients with HBeAg-positive CHB than.

关 键 词：慢性乙型肝炎 聚乙二醇干扰素Α-2A 延长疗程 

分 类 号：R512.62[医药卫生—内科学]