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    崔甫朦, 赵守松. HBsAg < 1 500 IU/mL的慢性乙型肝炎病人联合聚乙二醇干扰素α-2b治疗的疗效观察[J]. 蚌埠医科大学学报, 2021, 46(6): 735-739. DOI: 10.13898/j.cnki.issn.1000-2200.2021.06.008
    引用本文: 崔甫朦, 赵守松. HBsAg < 1 500 IU/mL的慢性乙型肝炎病人联合聚乙二醇干扰素α-2b治疗的疗效观察[J]. 蚌埠医科大学学报, 2021, 46(6): 735-739. DOI: 10.13898/j.cnki.issn.1000-2200.2021.06.008
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    CUI Fu-meng, ZHAO Shou-song. Clinical observation of the combined treatment with pegylated interferon α-2b in the treatment of chronic hepatitis B patients with HBsAg < 1 500 IU/mL[J]. Journal of Bengbu Medical University, 2021, 46(6): 735-739. DOI: 10.13898/j.cnki.issn.1000-2200.2021.06.008
    Citation: CUI Fu-meng, ZHAO Shou-song. Clinical observation of the combined treatment with pegylated interferon α-2b in the treatment of chronic hepatitis B patients with HBsAg < 1 500 IU/mL[J]. Journal of Bengbu Medical University, 2021, 46(6): 735-739. DOI: 10.13898/j.cnki.issn.1000-2200.2021.06.008
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    HBsAg < 1 500 IU/mL的慢性乙型肝炎病人联合聚乙二醇干扰素α-2b治疗的疗效观察

    Clinical observation of the combined treatment with pegylated interferon α-2b in the treatment of chronic hepatitis B patients with HBsAg < 1 500 IU/mL

      摘要
    • 摘要:
      目的将核苷（酸）类似物（NAs）治疗后达到乙型肝炎表面抗原（HBsAg）<1 500 IU/mL的慢性乙型肝炎（CHB）病人，联合聚乙二醇干扰素α-2b（Peg-IFNα-2b）治疗，分析联合治疗与NAs单药治疗HBsAg清除的差异。
      方法将55例NAs治疗后达到HBsAg<1 500 IU/mL的病人分为联合治疗组（NAs+Peg-IFNα-2b）和NAs治疗组（继续原NAs治疗计划），疗程48周，观察HBsAg清除率及影响HBsAg清除的相关因素。
      结果治疗48周末，联合组HBsAg清除率显著高于NAs组（P<0.01）；HBsAg水平随用药时间逐渐降低，联合组降低幅度高于NAs组（P<0.05）。基线HBsAg<327 IU/mL对48周疗程完成时HBsAg的清除有预测作用（P<0.05），AUC为0.828，cut-off值为327 IU/mL，敏感度为75.0%，特异度为87.5%；基线丙氨酸氨基转移酶（ALT）异常病人HBsAg清除率明显高于ALT水平正常的病人（P<0.01）。
      结论对于接受NAs治疗达到血清HBsAg低水平的病人联合Peg-IFNα-2b治疗可以提高HBsAg清除率，基线HBsAg<327 IU/mL对48周疗程结束时HBsAg的清除有预测作用，基线ALT水平高于正常水平上限更容易实现HBsAg清除。

       

      Abstract:
      ObjectiveTo compare the differences of HBsAg clearance between pegylated interferon α-2b(Peg-IFNα-2b) combinated with nucleoside(acid) analogue(NAs) therapy and NAs monotherapy in chronic hepatitis B(CHB) patients with HBsAg<1 500 IU/mL after treatment with NAs.
      MethodsAmong 55 patients with HBsAg<1 500 IU/mL after NAs treatment, the patients treated with NAs combined with Peg-IFNα-2b, and patients treated with NAs were divided into the combination treatment group and NAs treatment group, respectively, and two groups were treated for 48 weeks.The HBsAg clearance rate and related factors influencing the clearance rate of HBsAg in two groups were observed.
      ResultsAfter 48 weeks of treatment, the HBsAg clearance rate in combination treatment group was significantly higher than that in NAs treatment group(P<0.01).The HBsAg levels in two groups gradually decreased with the increasing of medication time, and the reduction in combination treatment group was higher than that in NAs treatment group(P<0.05).The baseline HBsAg<327 IU/mL has a predictive effect on the clearance of HBsAg at the end of the 48-week treatment course(P<0.05).The AUC, cut-off value, sensitivity and specificity were 0.828, 327 IU/mL, 75.0% and 87.5%, respectively.The HBsAg clearance rate of patients with abnormal baseline alanine aminotransferase(ALT) was significantly higher than patients with normal ALT(P<0.01).
      ConclusionsThe treatment of NAs combined with Peg-IFNα-2b in pateints with low serum level of HBsAg can improve the HBsAg clearance rate.The baseline HBsAg<327 IU/mL has a predictive effect on the clearance of HBsAg at the end of 48 weeks treatment, and the HBsAg clearance is more likely to be achieved with baseline ALT levels above the upper normal limit.

       

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