聚乙二醇干扰素α-2a联合恩替卡韦治疗老年慢性乙型肝炎的效果及影响因素  

Effect of polyethylene glycol interferon α-2a on elderly patients with chronic hepatitis B and analysis of influencing factors

作　　者：康晓 俞力[3] 王蕾 霍江波 黄莉 Kang Xiao;Yu Li;Wang Lei;Huo Jiangbo;Huang Li(Department of Gastroenterology,Capital Medical University Daxing Teaching Hospital,Beijing 102600,China)

机构地区：[1]首都医科大学大兴教学医院消化科,北京102600 [2]首都医科大学大兴教学医院超声科,北京102600 [3]首都医科大学附属北京友谊医院消化科

出　　处：《中国临床保健杂志》2020年第1期89-93,共5页Chinese Journal of Clinical Healthcare

摘　　要：目的探究聚乙二醇干扰素α-2a(pegIFNα-2a)联合恩替卡韦治疗老年慢性乙型肝炎(CHB)中乙型肝炎表面抗原(HBsAg)、乙型肝炎E抗原(HBeAg)、乙型肝炎病毒脱氧核糖核酸(HBV-DNA)的转阴情况及影响因素。方法选取110例CHB患者按随机数字表法分为常规组(50例)与联合组(60例)。所有患者均给予常规对症支持治疗,联合组则在此基础上加用pegIFNα-2a。两组CHB患者均连续治疗8周,观测其HBsAg、HBeAg、HBV-DNA的转阴情况,并对影响老年CHB患者HBsAg、HBeAg、HBV-DNA转阴的因素进行分析。结果治疗后,联合组患者的HBsAg、HBeAg、HBV-DNA的转阴率分别为18.3%,15.0%,86.7%,显著高于常规组的4.0%,0.0%,54.0%(P均<0.05)。经多因素logistic回归分析,患者治疗前谷氨酸氨基转移酶(ALT)水平≥1.5ULN和未使用干扰素治疗为影响老年CHB患者HBsAg和HBeAg转阴的独立危险因素(P<0.05),患者治疗前ALT水平≥1.5 ULN和未使用干扰素治疗以及治疗的依从性差为影响老年CHB患者HBV-DNA转阴的独立危险因素(P<0.05)。结论pegIFNα-2a联合恩替卡韦对老年CHB患者具有较好的治疗效果,可显著改善其HBsAg、HBeAg、HBV-DNA的转阴情况;ALT水平、治疗的依从性等均能影响临床治疗效果。Objective To investigate the negative conversion of hepatitis B surface antigen(HBsAg),hepatitis B E antigen(HBeAg)and hepatitis B virus deoxyribonucleic acid(HBV-DNA)in the treatment of elderly chronic hepatitis B(CHB)with peginterferonα-2a(pegIFNα-2a)and its influencing factors.Methods 110 elderly patients with CHB were randomly divided into the conventional group(50 cases)and the combined group(60 cases).All patients were given comprehensive symptomatic and supportive treatment in conventional internal medicine.pegIFNα-2a was added to the combined group.Two groups of elderly patients with CHB were treated continuously for 8 weeks.The negative conversions of HBsAg,HBeAg and HBV-DNA were observed,and the risk factors in elderly patients with CHB were analyzed.Results TAfter treatment,the negative conversion rates of HBsAg,HBeAg and HBV-DNA in the combined group were 18.3%,15.0%and 86.7%,respectively,which were significantly higher than those in the conventional group(4.0%,0.0%,54.0%,P<0.05).Multivariate Logistic regression analysis showed that alanine aminotransferase(ALT)≥1.5 ULN before treatment and interferon not used before treatment were independent risk factors for HBsAg and HBeAg negative conversion in elderly CHB patients(P<0.05).ALT≥1.5 ULN before treatment,interferon not used before treatment and poor compliance of patients with treatment were independent risk factors for HBV-DNA negative conversion in elderly CHB patients(P<0.05).Conclusion PegIFNα-2a combined with ticavir has a good therapeutic effect on elderly patients with CHB,which can significantly improve the negative conversion of HBsAg,HBeAg and HBV-DNA,and is worthy of clinical promotion.It is worth noting that both the level of ALT and treatment compliance can affect the clinical treatment effect.

关 键 词：乙型肝炎 慢性 干扰素Α 抗病毒药 影响因素分析 老年人 

分 类 号：R512.62[医药卫生—内科学]