重组人干扰素α-2b治疗慢性乙型肝炎出现甲癣样表现45例临床特征分析  

Analysis of Clinical Characteristics of 45 Patients with Onychomycosis-Like Manifestations in the Treatment of Chronic Hepatitis B with Interferon Alpha-2b

作　　者：宋志英 金堤 蓝玉 徐慧丽 吴志国 罗小露 邱芳 孙水林[1] SONG Zhiying;JIN Di;LAN Yu;XU Huili;WU Zhiguo;LUO Xiaolu;QIU Fang;SUN Shuilin(Department of Infectious Diseases,the Second Affiliated Hospital of Nanchang University,Nanchang 330008,China)

机构地区：[1]南昌大学第二附属医院,江西南昌330008

出　　处：《中国皮肤性病学杂志》2022年第4期413-417,共5页The Chinese Journal of Dermatovenereology

基　　金：江西省科技厅重点研发计划(20171BBG70086)。

摘　　要：目的探讨重组人干扰素α-2b(IFNα-2b)治疗慢性乙型肝炎(CHB)出现甲癣样表现病例45例的临床特征。方法收集南昌大学第二附属医院2005-2020年IFNα-2b治疗的2327例CHB患者中出现的45例甲癣样表现不良反应病例,分析该45例患者在IFNα-2b治疗过程中引起甲癣样表现的潜伏期、累及甲范围、甲病变特点、甲病变转归及CHB治疗效果。结果IFNα-2b治疗CHB出现甲癣样表现的发生率约为1.93%,潜伏期为2~72周,病变可累及所有指/趾甲。该不良反应的出现未影响血生化及肢体功能,可继续进行IFNα-2b治疗,继续治疗过程中6例患者甲病变自愈、39例患者甲病变不同程度加重且累及甲范围扩大,停用IFNα-2b后4~48周所有患者甲病变自愈。出现甲癣样表现的CHB患者HBV DNA阴转率、HBeAg阴转率、HBeAg血清学转换率较高。结论IFNα-2b治疗CHB可出现少见甲癣样表现不良反应;出现该不良反应不影响CHB的治疗,可继续IFNα-2b治疗,虽甲病变可加重、累及范围扩大,但无需特殊处理,停用IFNα-2b后甲病变可自愈;出现该不良反应的CHB患者临床抗病毒治疗疗效较好。Objective To explore the clinical characteristics of 45 cases of onychomycosis-like manifestations of chronic hepatitis B(CHB)treated with interferon alpha-2 b(IFNα-2 b).Methods Collected 45 cases of onychomycosis-like adverse reactions in 2327 CHB patients treated with IFNα-2 b in the Second Affiliated Hospital of Nanchang University from 2005 to 2020.The area of nail involvement,the characteristics of nail lesions,the outcome of nail lesions,and the effect of CHB treatment of 45 patients with onychomycosis-like appearance during IFNα-2 b treatment were analyzed.Results The incidence of onychomycosis-like manifestations in IFNα-2 b treatment of CHB was about 1.93%,the incubation period was 2 to 72 weeks,and the lesions could involve all nails.The occurrence of this adverse reaction did not affect blood biochemistry and limb function,and IFNα-2 b treatment can be continued.During the continued treatment,6 patients with nail lesions healed spontaneously,and the nail lesions were aggravated in varying degrees and the nail range was enlarged in 39 patients.The nail lesions of all patients recovered spontaneously 4 to 48 weeks after IFNα-2 b was stopped.CHB patients with onychomycosis-like manifestations had a higher rate of HBV DNA negative conversion,HBeAg negative conversion,and HBeAg seroconversion rate.Conclusion IFNα-2 b treatment of CHB may cause rare onychomycosis-like adverse reactions.The occurrence of this adverse reaction does not affect the treatment of CHB,and IFNα-2 b treatment can be continued.Although the nail lesions will be aggravated and the scope of involvement expand,special treatment is not required.Nail lesions can be cured after stopping IFNα-2 b.The clinical antiviral treatment effect of CHB patients with this adverse reaction is better.

关 键 词：干扰素α-2b(IFNα-2b) 慢性乙型肝炎(CHB) 甲癣样表现 不良反应 

分 类 号：R512.62[医药卫生—内科学] R758.7[医药卫生—临床医学]