恩替卡韦与干扰素治疗HBeAg阳性慢性乙型肝炎的疗效  

Comparison of effects of entecavir and interferon therapy for HBeAg-positive chronic hepatitis B

作　　者：潘玉[1] 王莉娜[1] 宋正霞 颜学兵[1] 丁芹[1] 

机构地区：[1]徐州医学院附属医院感染性疾病科,徐州市221006

出　　处：《中华实验和临床感染病杂志（电子版）》2016年第4期392-395,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：国家自然科学基金面上项目(No.81371867);江苏省高校自然科学基础研究(No.08KJD320012)

摘　　要：目的比较恩替卡韦与干扰素治疗HBe Ag阳性慢性乙型肝炎的疗效。方法入组69例患者分成两组,即恩替卡韦组(46例)与干扰素组(23例),收集HBe Ag阳性慢性乙型肝炎患者抗病毒治疗12、24、36和48周时的血清;并检测血清HBV DNA、HBe Ag、HBe Ab、血清丙氨酸氨基转移酶(ALT)的含量。结果在治疗12、24、36、48周时,恩替卡韦组患者血清HBV DNA低于检测下限的比率(82.6%、97.8%、97.8%和97.8%)显著高于干扰素组(34.8%、43.5%、47.8%和52.2%),差异均具有统计学意义(χ2=15.8、24.7、21.9、19.2,P均=0.00);治疗24、36、48周时干扰素组患者HBe Ag转阴率(34.8%、39.1%和43.5%)显著高于恩替卡韦组(4.3%、10.9%和17.4%),差异均有统计学意义(χ2=9.1、5.9、5.4,P=0.00、0.01、0.02);治疗24、36、48周时干扰素组患者HBe Ag血清学转换率(26.1%、30.4%和30.4%)显著高于恩替卡韦组(4.3%、4.3%和8.7%),差异均具有统计学意义(χ2=5.1、7.0、3.9,P=0.02、0.00、0.04);各治疗时间点恩替卡韦组患者ALT复常率(87%、97.8%、100%和100%)显著高于干扰素组(34.8%、73.9%、73.9%和65.2%),差异均有统计学意义(χ2=19.7、7.2、10.1、14.9,P均=0.00)。结论 HBe Ag阳性的慢性乙型肝炎患者,恩替卡韦治疗可获得更高的HBV DNA低于检测下限的比率,而干扰素治疗可获得更高的HBe Ag转阴率及血清学转换率。Objective To compare the therapeutic effects of entecavir and interferon for chronic hepatitis B patients with HBe Ag-positive. Methods The 69 cases were divided into two groups, entecavir group（46 cases） and interferon group（23 cases）. The serum of HBe Ag-positive patients with chronic hepatitis B who accepted entecavir or interferon antiviral therapy for 12, 24, 36 and 48 weeks were collected. Meanwhile, the amounts of HBV DNA, HBe Ag, HBe Ab, serum alanine aminotransferase were detected, respectively. Results At 12, 24, 36 and 48 weeks, the ratio of serum HBV DNA lower than the detection limit of entecavir group（82.6%, 97.8%, 97.8% and 97.8%） were significantly higher than those of interferon group（34.8%, 43.5%, 47.8% and 52.2%）（χ^2 = 15.8, 24.7, 21.9, 19.2; P all = 0.00）. At 24, 36 and 48 weeks, HBe Ag negative conversion rates of patients in interferon group（34.8%, 39.1% and 43.5%） were significantly higher than those of entecavir group（4.3%, 10.9% and 17.4%）（χ^2 = 9.1, 5.9, 5.4; P = 0.00, 0.01, 0.02）. At 24, 36 and 48 weeks, HBe Ag seroconversion rates of interferon group（26.1%, 30.4% and 30.4%） were significantly higher than those of entecavir group（4.3%, 4.3% and 8.7%）（χ^2 = 5.1, 7.0, 3.9; P = 0.02, 0.00, 0.04）. At 12, 24, 36, 48 weeks, ALT normalization rates of patients in entecavir group（87%, 97.8%, 100% and 100%） were higher than that of interferon group（34.8%, 73.9%, 73.9% and 65.2%）（χ^2 = 19.7, 7.2, 10.1, 14.9; P all = 0.00）. Conclusions HBe Ag-positive patients treated by entecavir could obtain higher ratio of serum HBV DNA lower than the detection limit, and those who accepted interferon could obtain higher rates of HBe Ag negative conversion rate and seroconversion rate.

关 键 词：肝炎 乙型 慢性 HBV DNA 恩替卡韦 干扰素 

分 类 号：R512.62[医药卫生—内科学]