两种联合抗病毒方案对耐药e抗原阳性乙肝患者血清学指标和ALT复常率及不良反应的影响  

Influence of Two Kinds of Combination Antiviral Regimens on Serum Parameters,ALT Normalization Rate and Adverse Reactions of Patients with Resistant e-antigen Positive Hepatitis B

作　　者：徐继尧 龙波[2] 罗大勇[2] 司果[2] 陈丹[2] 齐燕 刘翔 XU Jiyao;LONG Bo;LUO Dayong;SI Guo;CHEN Dan;QI Yan;LIU Xiang(Wuhan Medical and Health Association Joint Office,Wuhan 430014,China;The Affiliated Hospital of North Sichuan Medical College,Mianyang 621000,China;Renmin Hospital of Shiyan City,Renmin Hospital Affiliated with Hubei Uiversity of Medicine,Shiyan 442000,China)

机构地区：[1]武汉医药卫生学会联合办公室,武汉430014 [2]川北医学院附属第二医院,绵阳621000 [3]湖北省十堰市人民医院湖北医药学院附属人民医院,十堰442000

出　　处：《医药导报》2018年第7期846-849,共4页Herald of Medicine

摘　　要：目的观察阿德福韦酯与恩替卡韦分别联合聚乙二醇干扰素对耐药e抗原阳性乙型肝炎(乙肝)患者血清学指标、丙氨酸氨基转移酶(ALT)复常率及不良反应的影响。方法将耐药e抗原阳性乙肝患者100例随机分为两组各50例,均给予聚乙二醇干扰素180μg皮下注射,每周1次。A组口服阿德福韦酯10 mg,qd;B组口服恩替卡韦1 mg,qd。治疗时间均为72周。比较两组病毒学完全应答率、HBe Ag转阴率、HBe Ag血清转换率、HBV DNA转阴率、HBs Ag转阴率、ALT复常率及不良反应发生率等。结果两组治疗24,48,72周后病毒学完全应答率差异无统计学意义(P>0.05);B组治疗24,48,72周后HBe Ag血清转换率显著高于A组(P<0.05);两组治疗后HBe Ag转阴率、HBV DNA转阴率及HBs Ag转阴率差异无统计学意义(P>0.05);两组治疗24,48,72周后ALT复常率差异无统计学意义(P>0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论聚乙二醇干扰素联合恩替卡韦治疗耐药e抗原阳性乙肝,可有效提高HBe Ag血清转换率,改善总体疗效,且不增加不良反应发生风险。Objective To investigate the effect of adefovir dipivoxil and entecavir separately combined with pegylated interferon on serum parameters,ALT normalization rate and adverse reactions of patients with resistant e-antigen positive hepatitis B.Methods Totally,100 patients with resistant e-antigen positive hepatitis B were randomly divided into group A （50 patients,treated with adefovir dipivoxil combined with pegylated interferon and group B （50 patients,treated with entecavir combined with pegylated interferon）; The complete viral response rate,HBeAg negative conversion rate,HBeAg transfer rate,DNA HBV negative conversion rate,HBsAg negative conversion rate,ALT normalization rate and adverse reaction incidence of both groups were compared.Results There was no significant difference in the complete viral response rate 24,48 and 72 weeks after the treatment between the two groups （ P 〉0.05）.The HBeAg negative conversion rate 24,48 and 72 weeks after the treatment were significantly higher in group B than in group A （ P 〈0.05）.There were no significant differences in the HBeAg negative conversion rate,DNA HBV negative conversion rate and HBsAg negative conversion rate after the treatment between the two groups （ P 〉0.05）.There was no significant difference in the ALT normalization rate 24,48 and 72 weeks after the treatment between the two groups （ P 〉0.05）.There was no significant difference in the adverse reaction incidence between the two groups （ P 〉0.05）.Conclusion Compared with adefovir dipivoxil,entecavir combined with pegylated interferon can efficiently increase the HBeAg seroconversion rate,improve the overall clinical efficacy,but not increase the adverse reaction risk in patients with resistant e-antigen positive hepatitis B.

关 键 词：聚乙二醇干扰素 阿德福韦酯 恩替卡韦 耐药 E抗原阳性 肝炎 乙型 

分 类 号：R978.7[医药卫生—药品] R512.6[医药卫生—药学]