艾米替诺福韦联合聚乙二醇干扰素治疗慢性乙型肝炎低病毒血症患者疗效  

Efficacy of imitinib combined with pegylated interferon in the treatment of chronic hepatitis B patients with low viremia and its effect on liver function and hepatitis B virus RNA level in mononuclear cells

作　　者：吴迎凤 朱树华 周洁[1] Wu Yingfeng;Zhu Shuhua;Zhou Jie(Department of Infectious Diseases,Rugao Hospital Affiliated to Nantong University,Nantong 226500,China)

机构地区：[1]南通大学附属如皋医院感染科,226500 [2]南通大学附属医院感染科

出　　处：《中华保健医学杂志》2025年第1期85-88,共4页Chinese Journal of Health Care and Medicine

基　　金：江苏省科技项目(BK20201485)。

摘　　要：目的探讨艾米替诺福韦(TMF)联合聚乙二醇干扰素α-2b(peg-IFNα-2b)对慢性乙型肝炎(CHB)伴低病毒血症(LLV)患者的疗效、肝功能及单个核细胞乙型肝炎病毒(PBMC HBV)RNA水平的影响。方法前瞻性选取2021年2月~2023年2月于南通大学附属如皋医院接受治疗的120例CHB伴LLV患者,依据随机数表法分为联合组和对照组,每组各60例。对照组给予TMF治疗,联合组给予TMF联合peg-IFN治疗,两组均连续治疗24周。比较两组患者治疗后的临床疗效;比较两组患者治疗前后的肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)以及肝脏硬度检测(LSM)]变化情况;比较两组患者乙肝表面抗原(HBsAg)、E抗原(HBeAg)、乙肝病毒基因(HBV-DNA)、PBMC HBV RNA水平变化情况;比较两组患者治疗期间的不良反应。结果治疗后,联合组的治疗总有效率高于对照组的治疗总有效率(92.67%vs.81.67%),差异有统计学意义(χ^(2)=5.783,P<0.05)。治疗后,联合组的ALT、AST、LSM水平治疗前后差值高于对照组,差异有统计学意义(t=9.469、7.718、10.145,P<0.05);HBsAg、HBeAg、PBMC HBV RNA治疗前后差值均高于对照组,差异有统计学意义(t=16.517、2.471、7.931,P<0.05)。两组患者不良反应发生率比较差异无统计学意义(χ^(2)=0.196,P>0.05)。结论TMF联合peg-IFNα-2b能更有效地提高CHB伴LLV患者的临床疗效,改善肝功能,降低PBMC HBV RNA水平,有效抑制病情进展。Objective To explore the efficacy of emitinofovir(TMF)combined with pegylated interferonα-2b(peg-IFNα-2b)on the treatment of patients with chronic hepatitis B(CHB)accompanied by low-level viremia(LLV),as well as its impacts on liver function and mononuclear cell hepatitis B virus(PBMC HBV)RNA levels.Method A total of 120 CHB patients with LLV who were treated in our hospital from February 2021 to February 2023 were prospectively selected as the study subjects.They were divided into a combination group and a control group according to the random number table method,with 60 cases in each group.The control group received TMF treatment,while the combination group received TMF combined with peg-IFN treatment,and both groups were treated for 24 weeks.The clinical efficacy of the two groups after treatment was compared.The changes in liver function indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST),and liver stiffness measurement(LSM)],hepatitis B surface antigen(HBsAg),E antigen(HBeAg),hepatitis B virus gene(HBV-DNA),and PBMC HBV RNA levels before and after treatment were compared between the two groups.The adverse reactions during the treatment period were also compared.Results After treatment,the total effective rate of the combination group(92.67%)was higher than that of the control group(81.67%)(χ^(2)=5.783,P<0.05).The differences in HBsAg,HBeAg,PBMC HBV RNA,ALT,AST,and LSM levels before and after treatment in the combination group were higher than those in the control group(t=16.517,2.471,7.931,9.469,7.718,10.145,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.196,P>0.05).Conclusions TMF combined with peg-IFNα-2b can more effectively improve the clinical efficacy of CHB patients with LLV,improve liver function,reduce the PBMC HBV RNA level,and effectively inhibit the progression of the disease.

关 键 词：艾米替诺福韦 聚乙二醇干扰素Α-2B 慢性乙型肝炎 低病毒血症 单个核细胞乙型肝炎病毒RNA 肝功能 

分 类 号：R512.6[医药卫生—内科学]