聚乙二醇化干扰素α联合阿德福韦酯治疗HBeAg阳性慢性乙肝疗效观察  

Therapeutic Effect of Pegylated Interferon α combined with Adefovir Dipivoxil in the Treatment of HBeAg-positive Chronic Hepatitis B Patients

作　　者：熊清芳[1] 黄平[1] 钟艳丹[1] 冯晓宁[1] 王华利[1] 杨永峰[1] 

机构地区：[1]东南大学附属第二医院肝病科,江苏南京210003

出　　处：《湖北科技学院学报（医学版）》2016年第6期474-477,共4页Journal of Hubei University of Science and Technology(Medical Sciences)

基　　金：南京市医学重点科技发展项目(ZKX12039)

摘　　要：目的评估聚乙二醇化干扰素α(Peg-IFNα,PI)和阿德福韦酯(ADV)联合治疗HBeAg阳性慢性乙型肝炎(CHB)48周的临床疗效。方法将我科收治的HBeAg阳性CHB患者80例分为3个组,其中PI/ADV组25例,采用PI(180μg/周或1.0-1.5μg/kg/周,皮下)联合ADV(10 mg/d,口服);单用PI组20例;单用ADV组35例。比较治疗48周后三组谷丙转氨酶(ALT)复常率、HBV DNA转阴率(<500 IU/m L)、HBs Ag和HBeAg阴转率以及血清学转换率;HBs Ag和HBeAg下降水平。结果治疗48周时,PI/ADV组ALT复常率(84%)与PI组(55%)相比有统计学意义(P<0.05);PI/ADV组与ADV组(85.71%)相比无统计学意义(P>0.05)。PI/ADV组(76.0%)HBVDNA转阴率与PI组(45.0%)相比有统计学意义(P<0.05),与ADV组(80%)相比无统计学意义(P>0.05)。治疗48周PI/ADV组、PI组、ADV组HBeAg血清学转换率和阴转率分别为28.0%、25.0%、8.5%;32.0%、30.0%、14.28%,无统计学意义(P>0.05)。HBs Ag消失率PI/ADV组4.0%,PI组5.0%,ADV组0%,无统计学意义(P>0.05)。治疗48周PI/ADV组、PI组HBeAg和HBs Ag平均较基线下降分别为(312.23±288.36)S/CO、(347.70±294.81)S/CO;(7045.8±4173)IU/m L、(5495.2±1664.4)IU/m L比较无统计学意义(P>0.05);但与ADV组[(178.48±91.59)S/CO、(3071.8±2421.97)IU/m L]比较均有统计学意义(P<0.05)。结论 PI/ADV组比PI组有较高的ALT复常率和HBV DNA转阴率;PI/ADV组较ADV组HBs Ag、HBeAg下降较快;有一定的优势。Objective To observe the clinical effect of pegylated interferon α（ Peg-IFNα,PI） combined with adefovir dipivoxil（ ADV） in the treatment of HBeAg-positive chronic hepatitis B patients（ CHB）. Methods 80 patients were divided randomly into three groups： PI / ADV group（ Peg-IFNα,180 μg / week or 1. 0-1.5μg / kg / week,ADV,10 mg / day）,PI group and ADV group. All patients were treated for 48 weeks. The ALT normalization rate,HBV DNA negative conversion rate,and the HBeAg and HBs Ag seroconversion and clearance rates were evaluated. In addition,the levels of HBs Ag and HBeAg were also measured and compared with the basal levels. Results Compared with PI group,the ALT normalization rate and HBV-DNA negative conversion rate in PI / ADVgroup were significantly improved in HBeAg-positive CHB after treatment for 48 weeks（ P〈0. 05）,but there had no significant difference between PI / ADV group and ADV group. The HBeAg and HBs Ag seroconversion and clearance rates at 48 th week showed no statistical significance amont the three groups.The levels of HBeAg and HBs Ag at 48 th week in PI / ADV group was much lower than those of the ADV group（ P〈0. 05）,but it had no statistic significance as compared to PI group. Conclusion Therapeutic effect of pegylated interferon α combined with adefovir dipivoxil（ ADV） is superior to monotherapy in HBeAg-positive chronic hepatitis B patients.

关 键 词：慢性乙型 乙型肝炎E抗原 聚乙二醇干扰素Α 阿德福韦酯 

分 类 号：R512.6[医药卫生—内科学]