干扰素联合核苷(酸)类似物治疗慢性乙型肝炎的疗效观察

何艳，唐晓鹏，郑宣鹤等.类似物治疗慢性乙型肝炎的疗效观察 [J].临床肝胆病杂志, 2013, 29(2). 114-116

肝炎，乙型，慢性知识脉络干扰素类知识脉络核酸类，核苷酸类和核苷类知识脉络

何艳，唐晓鹏，郑宣鹤，姚运海，张权，张永红，陈军

中南大学湘雅二医院感染科,长沙,410011

2013年

114-116

知网,万方

目的 观察干扰素(IFN)与核苷(酸)类似物联合治疗慢性乙型肝炎的疗效.方法 选择慢性乙型肝炎病例207例,分别予聚乙二醇干扰素(PEG-IFNα-2a或IFNα-2b)治疗52周,随访24周,其中146例(A组)初始24周联合核苷(酸)类似物治疗(59例联合拉米夫定,56例联合阿德福韦酯,31例联合恩替卡韦),另61例单用IFN治疗(B组).结果 A、B组治疗结束时HBV DNA阴转率分别为86.3％ (126/146)、65.6％ (40/61)；ALT复常率87.7％(128/146)、76.5％(39/61)；HBeAg阴转率分别为69.3％(70/101)、40％(10/25)；HBsAg阴转率分别为30.1％ (44/146)、16.4％(10/61)；抗-HBs阳转率分别为26.7％(39/146)、11.5％ (7/61),差异均有统计学意义(P＜0.05).结论 IFN联合核苷(酸)类似物治疗慢性乙型肝炎的疗效优于单用IFN组. To obselvc tllc thcrapctltic cfflcacy of comblnation tllσ apy witl△ lllterfcron(IFN)and a nudcOside analogue br tre⒋ ting chronic hepat|tis B(CHB)patients. methods two-hunderd-and-seven paticn“ diagnosed wlth CHB were assigned to thc follow-ing tlealment groups:IFN in combinatlon Wlth a nude。 dc analogue(group A); IFN m。 notherapy(gltlup B) The paticn“ in group Awere fu1ther divided into threc combination trcatment sub-groups, according to thc particular nuclcOsidc ana1ogue administered: lamivudine (LAM;sub~grclup A1,n=59);adefovir dipivoxll(ADⅤ ;sub~group A2,n=56);and entecav (ETⅤ ;sub-group A3;n=31) Allof the paticnts recovcd p lated-IFN(cithcr IFN -2a or IFN -2b)± or52wccks The pdtients in group A rec0ved the combination therapy lslth nuclcOside analoguc immcdiatcly upon initlation of the IFN trcatment^nd lastlng for a total of24wccks, after、 vhich IFN mono- therapy1oTas caⅡ icd out ResuIts In groups A and B, rcspectively, 86 3C% and65.69% achieved undetcctabIc1evels of HBⅤ DNA at the cnd of tlcatmcnt Howcvcr,group A achicvcd a higher rate of alanine aminotransferasc(ALT) n。 rmdlizon ratc(87 7% vs. group B: 76.5%,P。