聚乙二醇干扰素治疗低水平HBsAg慢性乙肝患者疗效  

Efficacy analysis of pegylated interferon in patients with low-level HBsAg chronic hepatitis B

作　　者：李淑 彭雁忠 胡国信[2] 齐明华[2] 武敬[2] LI Shu;PENG Yanzhong;HU Guoxin;QI Minghua;WU Jing(School of Clinical Medicine,Peking University Shenzhen Hospital,Anhui Medical University,Shenzhen,Guangdong 518036,China;Department Of Infectious Diseases,Peking University ShenzhenHospital,Shenzhen,Guangdong 518036,China)

机构地区：[1]安徽医科大学北京大学深圳医院临床学院,广东深圳518036 [2]北京大学深圳医院感染性疾病科,广东深圳518036

出　　处：《中国热带医学》2020年第7期676-681,共6页China Tropical Medicine

基　　金：深圳市科技创新委员会资助项目(No.JCYJ20120616144140857)。

摘　　要：目的分析聚乙二醇干扰素(PEg-IFNα-2a、PEg-IFNα-2b)治疗低水平HBsAg慢性乙型病毒性肝炎(CHB)的临床疗效。方法采用回顾性研究,选取2017年1月1日-2019年1月1日于北京大学深圳医院感染性疾病科门诊就诊,HBsAg<500 IU/mL且开始使用聚乙二醇干扰素治疗的慢性乙型病毒性肝炎患者,分析在治疗第24周、第48周HBsAg清除率及相关疗效影响因素。结果共纳入88例患者,在0~48周达到HBsAg清除有45例,其中应答组与未应答组性别、HBsAg基线水平差异有统计学意义(P<0.05);达到HBsAg清除的45例中,24例使用PEg-IFNα-2a治疗,21例使用PEg-IFNα-2b治疗,两组HBsAg清除率差异无统计学意义(P=0.195);治疗第24周时新增HBsAg清除患者25例,经多因素分析,基线HBsAg水平差异有统计学意义(OR=0.991,95%CI=0.983~1.000,P=0.042);治疗第48周时新增HBsAg清除患者10例,经多因素分析,第24周HBsAg下降率有统计学意义(OR=1.063,95%CI=1.077~1.123,P=0.027)。结论聚乙二醇干扰素治疗HBsAg<500 IU/mL慢性乙型病毒性肝炎患者HBsAg清除率明显高于基线水平高者;PEgIFNα-2a、PEg-IFNα-2b疗效无差异。治疗过程中第24周HBsAg下降幅度可预测治疗48周时HBsAg清除率。ObjectiveTo analyze the clinical cure rate of pegylated interferon(PEg-IFNα-2 a, PEg-IFNα-2 b) in thetreatment of low-level HBs Ag chronic hepatitis B(CHB).MethodsChronic hepatitis B patients with HBs Ag <500 IU/m L whostarted treatment with pegylated interferon were selected in the Department of Infectious Diseases,Peking University ShenzhenHospital from January 1, 2017 to January 1, 2019. HBs Ag clearance rate and related influencing factors at 24 th week and 48 thweek of treatment were analyzed.ResultsTotally 88 patients were included,of which 45 people achieved HBs Ag clearanceduring the observation period(0-48 w). There were statistically significant differences in gender and baseline HBs Ag levelsbetween the responding and non-responding groups(P<0.05). And 24 were treated with PEg-IFNα-2 a, and 21 were treatedwith PEg-IFNα-2 b of the 45 people who achieved HBs Ag clearance.There was no statistical difference between the two groups(P = 0.385).Using multivariate analysis for 25 patients with HBs Ag clearance at week 24 of treatment,baseline HBs Ag levelswere statistically significant(OR= 0.991, 95% CI=0.983-1.000, P= 0.042). Using multivariate analysis for 10 patients withHBs Ag clearance at week 48 of treatment,the percentage decrease in HBs Ag at week 24 was statistically significan(tOR=1.063,95%CI=1.077-1.123,P=0.027).ConclusionPegylated interferon can obtain significantly higher HBs Ag clearance rate inpatients with low level HBs Ag<500 IU/m L chronic hepatitis B than those with high baseline.There was no difference in theefficacy of PEg-IFNα-2 a and PEg-IFNα-2 b.Percent decrease in HBs Ag at week 24 can predict HBs Ag clearance rate at week48 of treatment.

关 键 词：慢性乙型病毒性肝炎 聚乙二醇干扰素 HBSAG 低水平 清除 

分 类 号：R512.62[医药卫生—内科学]