低水平慢性乙型肝炎患者应用恩替卡韦与聚乙二醇干扰素α-2b联合治疗的效果研究  

Effect of Combination Therapy with Entecavir and Peginterferon α-2b in Patients with Low-level Chronic Hepatitis B

作　　者：江敏毓 陈桂敏 陈春 李康 李耀才[1] JIANG Minyu;CHEN Guimin;CHEN Chun;LI Kang;LI Yaocai(Department of Infectious Disease,Maoming People’s Hospital,Maoming,Guangdong 525000,China;Department of Cancer Center,Sun Yat-sen University,Guangzhou,Guangdong 510060,China)

机构地区：[1]茂名市人民医院感染科,广东茂名525000 [2]中山大学肿瘤防治中心,广东广州510050

出　　处：《中国医药指南》2025年第2期43-45,共3页Guide of China Medicine

摘　　要：目的评估恩替卡韦与聚乙二醇干扰素α-2b联合应用于治疗慢性乙型肝炎病毒(HBV)载量较低患者的治疗效果。方法选取2021年4月至2022年12月在茂名市人民医院感染科门诊就诊的124例低水平乙型肝炎患者,根据治疗方法分为两组,对照组(83例)接受恩替卡韦治疗,干预组(41例)采用恩替卡韦联合皮下注射聚乙二醇干扰素α-2b的方法进行治疗。比较两组干预后的血清丙氨酸氨基转移酶(ALT)、HBsAg、HBeAg水平以及甲胎蛋白(AFP)含量。同时,比较HBV-DNA载量低于15 U/ml、HBeAg血清学转换以及ALT水平恢复正常患者在两组中的分布差异。结果治疗后,两组ALT、HBeAb、HBeAb、AFP和HBV-DNA<15 U/ml的例数比较无差异(P>0.05);干预组HbsAg和HbeAg水平均低于对照组(P<0.05);干预组HbsAb、HBeAg血清学转换率和ALT复常率均高于对照组(P<0.05)。治疗后,干预组HBsAg水平中位数为19.07 kU/L,低于治疗前的91.85 kU/L(P<0.05);干预组HBsAb水平中位数为0.98 kU/L,高于治疗前的0.37 kU/L(P<0.05)。但ALT、HBeAg、HBeAb、AFP及HBV-DNA低于15 U/ml的例数在联合治疗前后比较,差异均无统计学意义(P>0.05)。结论恩替卡韦联合聚乙二醇干扰素α-2b治疗可降低低水平慢性乙型肝炎患者HbsAg和HbeAg水平,相较于单独使用恩替卡韦治疗效果更优。Objective To evaluate the therapeutic effect of combining entecavir with pegylated interferonα-2b in treating patients with low viral load chronic hepatitis B.Methods A total of 124 patients with low-level hepatitis B who visited the Infectious Disease Department outpatient clinic of Maoming People’s Hospital from April 2021 to December 2022 were selected and divided into two groups based on treatment methods:the control group(83 cases)received entecavir treatment,and the intervention group(41 cases)were treated with a combination of entecavir and subcutaneous injection of pegylated interferonα-2b.The levels of serum alanine aminotransferase(ALT),HBsAg,HBeAg and alpha-fetoprotein(AFP)content were compared between the two groups after intervention.Additionally,the distribution differences of patients with HBV-DNA load below 15 U/ml,HBeAg seroconversion,and normalization of ALT levels in the two groups were compared.Results After treatment,there was no difference in the number of cases with ALT,HBeAb,HBeAb,AFP,and HBV-DNA<15 U/ml between the two groups(P>0.05).The levels of HbsAg and HbeAg in the intervention group were both lower than those in the control group(P<0.05).The seroconversion rates of HbsAb and HBeAg,and the normalization rate of ALT in the intervention group were all higher than those in the control group(P<0.05).After treatment,the median level of HBsAg in the intervention group was 19.07 kU/L,which was lower than the pre-treatment level of 91.85 kU/L(P<0.05).The median level of HBsAb in the intervention group was 0.98 kU/L,which was higher than the pre-treatment level of 0.37 kU/L(P<0.05).However,there was no statistically significant difference in the number of cases with ALT,HBeAg,HBeAb,AFP,and HBV-DNA below 15 U/ml before and after combination treatment(P>0.05).Conclusions The combination of entecavir and pegylated interferonα-2b can reduce the levels of HbsAg and HbeAg in patients with low-level chronic hepatitis B,and the treatment effect is superior to that of entecavir alone.

关 键 词：慢性乙型肝炎 恩替卡韦 聚乙二醇干扰素Α-2B 联合治疗 

分 类 号：R512.62[医药卫生—内科学]