聚乙二醇干扰素α-2a联合恩替卡韦序贯治疗慢性乙型肝炎的效果分析  

Efficacy of peginterferon alfa-2a combined with entecavir in sequential treatment of chronic hepatitis B

作　　者：姜晓杰 史婷婷 韩胆 Jiang Xiaojie;Shi Tingting;Han Dan(Department of Pharmacy,Affiliated Hangzhou Xixi Hospital of Zhejiang University School of Medicine,Hangzhou 310000,Zhejiang Province,China;Department of Pharmacy,Affiliated Hangzhou First People's Hospital of Zhejiang University School of Medicine,Hangzhou 310000,Zhejiang Province,China)

机构地区：[1]浙江大学医学院附属杭州市西溪医院药学部,杭州310000 [2]浙江大学医学院附属杭州市第一人民医院药学部,杭州310000

出　　处：《中国基层医药》2023年第8期1211-1215,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的分析聚乙二醇干扰素α-2a(Peg-IFNα-2a)联合恩替卡韦序贯治疗慢性乙型肝炎(CHB)患者的效果。方法选取2020年1月至2022年2月在浙江大学医学院附属杭州市西溪医院诊治的CHB患者106例为研究对象,根据治疗方法不同分为对照组(恩替卡韦治疗)53例和研究组53例(Peg-IFNα-2a联合恩替卡韦序贯治疗),比较两组治疗前后的肝功能指标、肝纤维化指标,以及临床治疗疗效和不良反应发生情况。结果治疗后,对照组和研究组总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)分别为(94.79±8.71)μmol/L和(67.67±9.19)μmol/L、(256.93±44.07)U/L和(186.56±48.37)U/L、(256.47±43.73)U/L和(200.69±41.34)U/L,较治疗前的(140.05±26.15)μmol/L和(141.32±25.35)μmol/L、(433.66±77.16)U/L和(429.77±73.73)U/L、(352.34±65.19)U/L和(354.05±66.13)U/L均降低(t=19.19、-12.13,-28.85、-20.96,-19.27、-12.03,均P<0.05),且研究组均低于对照组(t=-6.49、-7.30、-6.74,均P<0.001)。治疗后,对照组和研究组透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原肽(PCⅢ)、Ⅳ型胶原(Ⅳ-C)分别为(124.91±22.99)μg/L和(101.29±22.67)μg/L、(132.71±25.37)μg/L和(110.56±25.49)μg/L、(116.93±20.29)μg/L和(93.14±20.39)μg/L、(63.14±12.19)μg/L和(50.81±11.63)μg/L,较治疗前的(175.73±48.56)μg/L和(177.61±48.51)μg/L、(163.43±41.52)μg/L和(165.57±41.59)μg/L、(139.71±31.75)μg/L和(141.72±31.78)μg/L、(106.97±32.24)μg/L和(104.02±34.12)μg/L均降低(t=-13.04、-8.68、-10.43、-5.82、-13.35、-6.26、-13.02、-10.72,均P<0.05),且研究组均低于对照组(t=-5.32、-4.48、-6.02、-5.32,均P<0.001)。研究组治疗总有效率为88.68%(47/53),明显高于对照组的62.26%(33/53)(χ^(2)=9.98,P<0.05),研究组HBsAg转阴率为33.96%(18/53),明显高于对照组的1.32%(6/53)(χ^(2)=7.75,P<0.05)。研究组与对照组不良反应发生率差异无统计学意义[26.42%(14/53)比30.19%(16/53),χ^(2)=0.81,P>0.05]。结论Peg-IFNα-2a�Objective To investigate the efficacy of peginterferon alfa-2a(Peg-IFNα-2a)combined with entecavir in sequential treatment of chronic hepatitis B.Methods A total of 106 patients with chronic hepatitis B who received treatment in Affiliated Hangzhou Xixi Hospital of Zhejiang University School of Medicine from January 2020 to February 2022 were included in this study.They were divided into a control group(entecavir treatment,n=53)and a study group(sequential therapy with Peg-IFNα-2a followed by entecavir,n=53).Liver function indicators,liver fibrosis indicators,clinical treatment efficacy,and incidence of adverse reactions were compared between the two groups before and after treatment.Results After treatment,total bilirubin,alanine aminotransferase and aspartate transaminase in the control and study groups were(94.79±8.71)μmol/L and(67.67±9.19)μmol/L,(256.93±44.07)U/L and(186.56±48.37)U/L,(256.47±43.73)U/L and(200.69±41.34)U/L,and they were(140.05±26.15)μmol/L and(141.32±25.35)μmol/L,(433.66±77.16)U/L and(429.77±73.73)U/L,(352.34±65.19)U/L and(354.05±66.13)U/L before the treatment.After treatment,these indexes in each group were decreased compared with before treatment(t=19.19,-12.13,-28.85,-20.96,-19.27,-12.03,all P<0.05).After treatment,these indexes in the study group were significantly lower than those in the control group(t=-6.49,-7.30,-6.74,all P<0.001).After treatment,the levels of hyaluronic acid,laminin,typeⅢprocollagen peptide,and typeⅣcollagen in the control and study groups were(124.91±22.99)μg/L and(101.29±22.67)μg/L,(132.71±25.37)μg/L and(110.56±25.49)μg/L,(116.93±20.29)μg/L and(93.14±20.39)μg/L,(63.14±12.19)μg/L and(50.81±11.63)μg/L,and they were(175.73±48.56)μg/L and(177.61±48.51)μg/L,(163.43±41.52)μg/L and(165.57±41.59)μg/L,(139.71±31.75)μg/L and(141.72±31.78)μg/L,(106.97±32.24)μg/L and(104.02±34.12)μg/L before treatment.After treatment,the levels of these indexes in each group were significantly decreased compared with before treatment(t=-13.0

关 键 词：肝炎 乙型 慢性 胆红素 丙氨酸转移酶 天冬氨酸氨基转移酶类 聚乙二醇干扰素Α-2A 恩替卡韦 

分 类 号：R512.62[医药卫生—内科学]