恩替卡韦联合a-2b干扰素治疗慢性乙型肝炎的疗效观察

    Effect of entecavir combined with a-2b interferon on treatment of chronic hepatitis B

    • 摘要: 目的:探讨恩替卡韦联合a-2b干扰素(a-2b IFN)治疗高病毒载量慢性乙型肝炎(CHB)的临床疗效。方法:将90例CHB患者随机分为恩替卡韦组(A组),a-2b IFN组(B组),恩替卡韦(用药4周)联合a-2b IFN组(C组),每组30例。疗程均为48周。检测3组患者治疗12周、24周、48周时丙氨酸氨基转移酶(ALT)、HBV DNA及HBV血清标志物(乙肝五项)的变化。结果:治疗12周后,3组患者HBV DNA不可检测率、HBeAg的阴转率、HBeAg血清学转换率和ALT复常率差异均无统计学意义(P>0.05)。治疗24周后,3组患者的HBV DNA不可检测率、HBeAg阴转率和HBeAg转换率差异均无统计学意义(P>0.05),C 组ALT复常率高于B组(P<0.05),而A组与B组ALT复常率差异无统计学意义(P>0.05)。治疗48周后,C组患者的HBeAg阴转率和ALT复常率均高于A组和B组(P<0.05),而A组与B组的4项指标差异均无统计学意义(P>0.05)。结论:恩替卡韦用药4周后联合a-2b IFN治疗高病毒载量CHB优于单药治疗组,值得临床推广。

       

      Abstract: Objective:To explore the effect of entecavir combined with a-2b interferon(a-2b IFN) on the treatment of chronic hepatitis B(CHB).Methods:Ninety CHB patients were randomly divided into three groups:entecavir group(group A),a-2b IFN group(group B) and entecavir combined with a-2b IFN group(group C),30 cases each group.The course of the treatment in every group was 48 weeks.The changes of serum alanine aminotransferase(ALT) level,HBV DNA and the five items of hepatitis at 12th week,24th week and 48th week after treatment were monitored respectively.Results:After treatment for 12 weeks,there were no statistical differences(P>0.05)among the three groups about the following four indexes,the negative rate of HBV DNA,the negative conversion ratio of HBeAg,the seroconversion ratio of HBeAg and the normalization rate of ALT.After treatment for 24 weeks,there were no statistical differences(P>0.05)among the three groups about the negative rate of HBV DNA,the negative conversion ratio of HBeAg and the seroconversion ratio of HBeAg.The normalization rate of ALT in group C was higher than in group B(P<0.05);and no statistical difference(P>0.05)between group A and group B.After 48 week,the negative conversion ratio of HBeAg and the normalization rate of ALT in group C were higher than those in group A and group B(P<0.05).And there were no statistical differences(P>0.05)between group A and group B of the four indexes.Conclusions:The curative effect of entecavir combined with a-2b interferon treatment for CHB with high viral load is superior than single drug treatment.The drug combination treatment is worth promoting in the clinic.

       

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