干扰素α-1b序贯拉米夫定联合治疗对慢性乙型肝炎患儿肝纤维化、ALT复常率和HBsAg水平的影响  

Effects of interferon α-1b combined with lamivudine on hepatic fibrosis,ALT normalization rate and HBsAg level in children with chronic hepatitis B

作　　者：李博[1] 郑欢伟[1] Li Bo;Zheng Huanwei(No.5 Hospital of Shijiazhuang City,Shijiazhuang 050024,China)

机构地区：[1]河北省石家庄市第五医院

出　　处：《广西医科大学学报》2019年第10期1580-1584,共5页Journal of Guangxi Medical University

基　　金：2018年度河北省医学科学研究重点计划课题资助项目(No.20181073)

摘　　要：目的:研究干扰素α-1b序贯拉米夫定联合治疗对慢性乙型肝炎患儿肝纤维化、血清病毒学水平和生活质量的影响。方法:选取2015年11月至2017年5月河北省石家庄市第五医院收治的136例慢性乙型肝炎患儿,按随机数字表法分为研究组和对照组,每组68例。对照组给予干扰素α-1b治疗,研究组给予干扰素α-1b序贯拉米夫定联合治疗。比较两组治疗前、后肝纤维化指标[透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原肽(PⅢP)、Ⅳ型胶原(CⅣ)]、乙肝表面抗原(HBsAg)、丙氨酸转氨酶(ALT)复常率和不良反应发生率。结果:两组HA、LN、PⅢP、CⅣ和HBsAg水平均随时间延长呈下降趋势。研究组治疗后1个、3个、6个月HA水平低于对照组,治疗后3个、6个月LN水平低于对照组,治疗后6个月PⅢP、CⅣ水平低于对照组(P<0.05),治疗后6个月ALT复常率高于对照组(P<0.05)。两组治疗前及治疗后1个、3个、6个月HBsAg水平及不良反应总发生率比较,差异均无统计学意义(均P>0.05)。结论:干扰素α-1b序贯拉米夫定联合治疗小儿慢性乙型肝炎可以明显延缓患儿肝纤维化进展,有效增强抗病毒疗效,促进肝功能恢复,且不增加不良反应的发生。Objective:To study the effect of interferonα-1 b combined with lamivudine on hepatic fibrosis,serum virological status and quality of life in children with chronic hepatitis B.Methods:From November 2015 to May 2017,136 children with chronic hepatitis B in our hospital were enrolled,and randomly divided into a study group and a control group,with 68 cases in each group.Children in the control group received interferonα-1 b therapy,and those in the study group received interferonα-1 b combined with lamivudine.The levels of hyaluronic acid(HA),laminin(LN),typeⅢprocollagen peptide(PⅢP),typeⅣcollagen(CⅣ)and HBs Ag,the alanine transaminase(ALT)normalization rate,and the incidence of adverse reactions were compared between the two groups before and after treatment.Results:The levels of HA,LN,PⅢP,CⅣand HBs Ag in both groups decreased with time.The level of HA in the study group was lower than that in the control group on 1,3 and 6 months after treatment,and the level of LN on 3 and 6 months after treatment was lower than that in the control group.On 6 months post-treatment,the level of CⅣand the ALT normalization rate in the study group were lower than those in the control group(P<0.05).There was no significant difference in the level of HBs Ag and the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Interleukin-1 b sequential lamivudine combined treatment could inhibit the progress of liver fibrosis,enhance the antiviral effect and promote the recovery of liver function in chronic hepatitis B children,and did not increase the incidence of adverse reactions.

关 键 词：慢性乙型肝炎 小儿 干扰素 拉米夫定 肝纤维化 丙氨酸转氨酶复常率 HBsAg 

分 类 号：R512.62[医药卫生—内科学]