IFNα-2b治疗323例HBeAg阳性慢性乙型肝炎的效果  

IFNα-2b Antiviral Therapy in 323 Patients with HBeAg-positive Chronic Hepatitis B

作　　者：徐慧丽 吴志国 孙水林[1] XU Hui-li;WU Zhi-guo;SUN Shui-lin(Department of Infectious Diseases,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Infectious Diseases,Sinopharm Dongfeng General Hospital,Shiyan 442000,China)

机构地区：[1]南昌大学第二附属医院感染科,南昌330006 [2]国药东风总医院感染性病科,湖北十堰442000

出　　处：《南昌大学学报（医学版）》2024年第3期1-5,共5页Journal of Nanchang University：Medical Sciences

基　　金：国家自然科学基金资助项目(818601113)。

摘　　要：目的 探讨IFNα-2b抗病毒治疗乙型肝炎e抗原(HBeAg)阳性慢性乙型肝炎(CHB)患者的效果。方法回顾性分析2010年1月至2014年1月就诊于南昌大学第二附属医院并接受IFNα-2b治疗的323例HBeAg阳性CHB患者的临床资料,按丙氨酸氨基转移酶(ALT)水平将其分为3组:ALT<2×ULN(A1组,n=111)、2×ULN≤ALT≤5×ULN(A2组,n=111)以及ALT>5×ULN(A3组,n=101)。观察临床疗效及不良反应,并比较3组间的抗病毒效果。结果 在停药时及停药后第12、24、48、72、96、144、192、240周,323例患者的HBV-DNA阴转率分别为39.9%、40.2%、39.0%、36.2%、34.1%、33.4%、31.3%、30.7%、30.7%;HBsAg阴转率分别为6.2%、6.2%、6.2%、5.9%、5.9%、5.9%、5.6%、5.6%、5.6%;HBeAg血清学转换率分别为28.2%、31.0%、32.8%、34.4%、33.7%、33.1%、32.8%、32.5%、31.6%。在各随访时间点,3组患者的HBV-DNA阴转率和HBeAg血清学转换率比较,A3组显著高于A2组,A2组显著高于A1组(P<0.05);3组患者的HBsAg阴转率比较,差异无统计学意义(P>0.05)。323例患者均出现发热及类流感样症状,238例(73.7%)出现白细胞及中性粒细胞降低,35例(10.8%)甲状腺功能异常,5例(1.5%)斑秃,1例(0.3%)睡眠障碍,经过密切观察和对症处理后,患者均顺利完成疗程,各指标均基本正常。结论 IFNα-2b治疗HBeAg阳性CHB患者在停药时及停药后随访期间均表现出较好的效果,大多数患者可耐受IFNα-2b的不良反应。IFNα-2b的抗病毒效果可能与ALT水平有关。Objective To investigate the efficacy of IFNα-2b antiviral therapy in patients with hepatitis B e antigen(HBeAg)-positive chronic hepatitis B(CHB).Methods The clinical data of 323 HBeAg-positive CHB patients who attended the Second Affiliated Hospital of Nanchang University and received IFNα-2b from January 2010 to January 2014 were retrospectively analyzed,and they were divided into 3 groups according to alanine aminotransferase(ALT)levels:ALT<2×ULN(group A1,n=111),2×ULN≤ALT≤5×ULN(group A2,n=111),and ALT>5×ULN(A3 group,n=101).The clinical efficacy and adverse reactions between the 3 groups were observed and the antiviral effects were compared.Results At the time of discontinuation and at weeks 12,24,48,72,96,144,192,and 240 weeks after discontinuation,the HBV-DNA negative conversion rates of the 323 patients were 39.9%,40.2%,39.0%,36.2%,34.1%,33.4%,31.3%,30.7%,and 30.7%,respectively;the HBsAg negative conversion rates were 6.2%,6.2%6.2%,5.9%,5.9%,5.9%,5.6%,5.6%,5.6%,respectively;the HBeAg serological conversion rates were 28.2%,31.0%,32.8%,34.4%,33.7%,33.1%,32.8%,32.5%,31.6%,respectively.At each follow-up time point,the HBV-DNA negative conversion rate and HBeAg seroconversion rate were significantly higher in group A3 than those in group A2,and they were significantly higher in group A2 than those in group A1(P<0.05);the difference in the HBsAg negative conversion rate of the three groups of patients was not statistically significant(P>0.05).All 323 patients had fever and influenza-like symptoms;238(73.7%)had decreased leukocytes and neutrophils;35 patients(10.8%)had abnormal thyroid function;5 patients(1.5%)had baldness;1 patient(0.3%)had sleep disorders.After close observation and symptomatic treatment,the patients successfully completed the course of treatment,and all the indexes were basically normal.Conclusion IFNα-2b antiviral therapy for HBeAg-positive CHB patients can yield positive clinical outcomes at the time of discontinuation and during the post-discontinuation follow-up period,and the m

关 键 词：HBEAG阳性 慢性乙型肝炎 IFNΑ-2B 疗效 

分 类 号：R512.62[医药卫生—内科学]