长效干扰素α-2b联合阿德福韦酯或恩替卡韦治疗耐药HBeAg阳性乙型肝炎疗效及安全性比较  

Comparison of clinical efficacy and safety of interferonα-2b combined with adefovir dipivoxil or entecavir in the treatment of drug-resistant e-antigen-positive hepatitis B

作　　者：沙尼亚·尼亚孜[1] 柯比努尔·吐尔逊 潘珂君[1] 孙晓风[1] SHANIYA·Niyazi;KEBINUER·Tuerxun;PAN Ke-jun;SUN Xiao-feng(Infectious Disease Center,the first Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院感染性疾病中心,830054

出　　处：《肝脏》2020年第7期746-748,779,共4页Chinese Hepatology

基　　金：新疆维吾尔自治区自然科学基金项目(2017D01C17)。

摘　　要：目的比较长效干扰素α-2b联合阿德福韦酯或恩替卡韦治疗耐药e抗原阳性乙型肝炎的临床效果及安全性。方法研究纳入86例耐药e抗原阳性乙型肝炎患者,均来自新疆医科大学第一附属医院2016年10月—2018年1月收治。以随机数字表法将患者分成各43例的两组,其中以长效干扰素α-2b联合阿德福韦酯治疗的患者归为A组,以长效干扰素α-2b联合恩替卡韦治疗的患者归为B组。治疗24、48周及随访24周,比较两组的治疗应答(病毒学和生化学应答)情况、血清学各指标(HBeAg血清学转换及HBeAg、HBsAg和HBV DNA转阴)和用药安全性。结果治疗24、48周及随访24周,B组患者的HBeAg血清学转换情况均优于A组(P<0.05),两组治疗应答、HBeAg转阴、HBsAg转阴和HBV DNA转阴情况及治疗期间的不良反应情况比较差异较小(P>0.05)。结论长效干扰素α-2b联合阿德福韦酯或恩替卡韦治疗耐药e抗原阳性乙型肝炎均具有较好的临床治疗效果。其中,恩替卡韦参与的联合治疗方案能明显改善患者的HBeAg血清学转换情况,应用价值更高。Objective To compare the clinical efficacy and safety of interferonα-2b combined with adefovir dipivoxil or entecavir in the treatment of drug-resistant e-antigen positive hepatitis B.Methods 86 patients with drug-resistant e-antigen positive hepatitis B were admitted from the First Affiliated Hospital of Xinjiang Medical University from October 2016 to January 2018.The patients were divided into two groups by random number table.The patients treated with interferonα-2b combined with adefovir dipivoxil were divided into group A and those treated with interferonα-2b combined with entecavir were divided into group B.After 24,48 weeks of treatment and 24 weeks of follow-up,the therapeutic responses(virological and biochemical responses),serological indicators(HBeAg seroconversion and negative HBeAg,HBsAg and HBV DNA)and drug safety were compared between the two groups.Results After 24,48 weeks of treatment and 24 weeks of follow-up,the serological conversion of HBAg in group B was better than that in group A(P<0.05).The treatment response,HBeAg negative,HBsAg negative,HBV DNA negative and adverse reactions during treatment in the two groups have no significant(P>0.05).Conclusion Interferonα-2b combined with adefovir dipivoxil or entecavir is effective in the treatment of drug-resistant hepatitis B with e antigen positive.Among them,the combination therapy of entecavir can significantly improve the serological conversion of HBeAg in patients with higher application value.

关 键 词：长效干扰素α-2b 阿德福韦酯 恩替卡韦 耐药e抗原阳性 乙型肝炎 

分 类 号：R51[医药卫生—内科学]