IFN-α抗病毒治疗118例慢性乙型肝炎并10年随访分析  

A Ten-year Follow-up of IFN-αAntiviral Therapy in 118 Patients with Chronic Hepatitis B

作　　者：龙林 吴志国 周瑶 向海鸿 邱芳 罗小露 刘翠芸[1] 孙水林[1] LONG Lin;WU Zhi-guo;ZHOU Yao;XIANG Hai-hong;QIU Fang;LUO Xiao-lu;LIU Cui-yun;SUN Shui-lin(Department of Infectious Diseases,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Medical Service,Chongqing Construction Hospital,Chongqing 400050,China)

机构地区：[1]南昌大学第二附属医院感染科,南昌330006 [2]重庆建设医院医务科,重庆400050

出　　处：《南昌大学学报（医学版）》2024年第3期6-10,37,共6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IFN-α抗病毒治疗慢性乙型肝炎(CHB)患者的效果,为CHB的抗病毒治疗提供参考。方法选取接受普通IFN-α治疗且资料完整的CHB患者118例,通过门诊定期复诊和电话随诊收集患者的乙肝五项[乙型肝炎表面抗原(HBsAg)、乙型肝炎表面抗体(HBsAb)、乙型肝炎e抗原(HBeAg)、乙型肝炎e抗体(HBeAb)、乙型肝炎核心抗体(HBcAb)]、乙肝DNA定量(HBV-DNA)和谷丙转氨酶(ALT)水平。比较治疗前后、随访期间不同时间点的HBV-DNA和HBsAg阴转率、HBeAg/HBeAb血清转换率和ALT复常率等。结果 HBV-DNA阴转率及HBsAg阴转率随治疗时间的延长而提高,HBV-DNA阴转率在治疗第24、36、48周时的阴转率明显高于第12周,HBsAg阴转率在治疗第48周明显高于第12周和24周,差异均有统计学意义(P<0.05)。停药后第24~432周各随访节点HBV-DNA阴转率及HBsAg阴转率呈先降后趋于稳定的趋势。HBeAg/HBeAb血清转换率随治疗时间的延长而升高,治疗第48周其转换率明显高于第12周(P<0.05);HBeAg/HBeAb血清转换率及SVR随停药时间的延长呈先降后趋于稳定的趋势。停药后,HBeAg/HBeAb血清转换率在各随访节点差异均无统计学意义(P>0.05)。病毒学复发率停药后先上升,在停药第144周呈现稳定趋势。ALT复常率在停药第144周呈现稳定趋势,停药第144周的ALT复常率明显高于停药第12周(P<0.05)。结论 IFN-α抗病毒治疗CHB可取得较好的疗效,在治疗及停药后各随访节点,HBV-DNA阴转率、HBsAg阴转率、ALT复常率、HBeAg/HBeAb转换率均可获得较高的应答率。Objective To investigate the efficacy of IFN-alpha antiviral therapy in patients with chronic hepatitis B(CHB)so as to provide a reference for CHB antiviral therapy in clinical practice.Methods 118 patients with CHB who were treated with regular IFN-αand had complete data were included in the study;the patients'hepatitis B penta-scores[hepatitis B surface antigen(HBsAg),hepatitis B surface antibody(HBsAb),hepatitis B e antigen(HBeAg),hepatitis B e antibody(HBeAb),hepatitis B core antibody(HBcAb)],quantitative hepatitis B DNA(HBV-DNA)and alanine transaminase(ALT)levels were collected through regular outpatient follow-ups and telephone follow-ups.HBV-DNA and HBsAg negative conversion rates,HBeAg/HBeAb seroconversion rates,and ALT reversion rates were compared before and after treatment,and at different time points during the follow-up period.Results The HBV-DNA-negative rate and the HBsAg-negative rate increased with the duration of treatment:HBV-DNA-negative rate was significantly higher at the 24th,36th,and 48th weeks after treatment than at the 12th week;HBsAg-negative rate was significantly higher at the 48th week than at the 12th and 24th weeks;the differences were statistically significant(P<0.05).A decreasing and then stabilizing tendency in the HBV-DNA-negative rate and the HBsAg-negative rate was observed at each follow-up node from week 24 to 432 after discontinuation.The HBeAg/HBeAb seroconversion rate increased with the duration of treatment and it was significantly higher at the 48th week than at the 12th week(P<0.05).A decreasing and then stabilizing tendency in the HBeAg/HBeAb seroconversion rate and the rate of sustained virological response was observed with the prolongation of discontinuation of the drug.After discontinuation,the differences in the HBeAg/HBeAb seroconversion rates were not statistically significant at each follow-up node(P>0.05).The virological relapse rate increased first after drug discontinuation and registered a stabilizing trend at the 144th week of drug discontinuation.The

关 键 词：慢性乙型肝炎 抗病毒治疗 IFN-Α 疗效 

分 类 号：R512.62[医药卫生—内科学]