中华实验和临床病毒学杂志
中華實驗和臨床病毒學雜誌
중화실험화림상병독학잡지
CHINESE JOURNAL OF EXPERIMENTAL AND CLINICAL VIROLOGY
2012年
2期
114-116
,共3页
倪勤%谢天胜%李敏伟%刘克洲
倪勤%謝天勝%李敏偉%劉剋洲
예근%사천성%리민위%류극주
肝炎,乙型,慢性%二环化合物%干扰素α-2a%肝炎/治疗
肝炎,乙型,慢性%二環化閤物%榦擾素α-2a%肝炎/治療
간염,을형,만성%이배화합물%간우소α-2a%간염/치료
Hepatitis B Chronic%Bicyclol compounds%Interteron Alfa-2a%Hepatitis/therapy
目的 探讨慢性乙型肝炎患者接受聚乙二醇干扰素-2a(派罗欣)±核苷(酸)类似物(NUC)治疗前和治疗早期转氨酶明显升高者,联合双环醇(百赛诺)治疗的疗效.方法 收集HBeAg阳性/阴性慢性乙型肝炎患者,给予派罗欣180 μg,每周一次,皮下注射,疗程48周以上,治疗结束后随访26周.HBV DNA≥1×108拷贝/ml者联合NUC(阿德福韦或恩替卡韦).治疗前ALT＞ 500 U/L或派罗欣治疗第一针后ALT＞ 300 U/L者联用双环醇25 mg,每日3次,治疗1～2个月.治疗前2 × ULN＜ ALT ＜300 U/L或治疗后ALT＜ 300 U/L者单用抗病毒治疗.比较两组患者的治疗应答和不良反应状况.结果总计54例患者(HBeAg阳性44例,HBeAg阴性10例)完成治疗及随访,其中20例联用双环醇(联合治疗组),34例未联用双环醇(对照组).结果 显示双环醇联合治疗组于治疗后ALT水平逐周下降,4周后有90％( 18/20)患者ALT＜ 200 U/L,对照组为85.3％ (29/34例).随访26周时两组ALT复常率分别为80％(16/20)和85.3％ (29/34)；病毒学应答率相仿,联合治疗组较对照组HBsAg血清学转换率有明显增高(P =0.044),分别为30％ (6/20)和11.8％(4/34).结论 双环醇可明显缓解干扰素治疗诱导的转氨酶升高反应,确保干扰素治疗顺利进行,且不影响其抗病毒疗效.
目的 探討慢性乙型肝炎患者接受聚乙二醇榦擾素-2a(派囉訢)±覈苷(痠)類似物(NUC)治療前和治療早期轉氨酶明顯升高者,聯閤雙環醇(百賽諾)治療的療效.方法 收集HBeAg暘性/陰性慢性乙型肝炎患者,給予派囉訢180 μg,每週一次,皮下註射,療程48週以上,治療結束後隨訪26週.HBV DNA≥1×108拷貝/ml者聯閤NUC(阿德福韋或恩替卡韋).治療前ALT＞ 500 U/L或派囉訢治療第一針後ALT＞ 300 U/L者聯用雙環醇25 mg,每日3次,治療1～2箇月.治療前2 × ULN＜ ALT ＜300 U/L或治療後ALT＜ 300 U/L者單用抗病毒治療.比較兩組患者的治療應答和不良反應狀況.結果總計54例患者(HBeAg暘性44例,HBeAg陰性10例)完成治療及隨訪,其中20例聯用雙環醇(聯閤治療組),34例未聯用雙環醇(對照組).結果 顯示雙環醇聯閤治療組于治療後ALT水平逐週下降,4週後有90％( 18/20)患者ALT＜ 200 U/L,對照組為85.3％ (29/34例).隨訪26週時兩組ALT複常率分彆為80％(16/20)和85.3％ (29/34)；病毒學應答率相倣,聯閤治療組較對照組HBsAg血清學轉換率有明顯增高(P =0.044),分彆為30％ (6/20)和11.8％(4/34).結論 雙環醇可明顯緩解榦擾素治療誘導的轉氨酶升高反應,確保榦擾素治療順利進行,且不影響其抗病毒療效.
목적 탐토만성을형간염환자접수취을이순간우소-2a(파라흔)±핵감(산)유사물(NUC)치료전화치료조기전안매명현승고자,연합쌍배순(백새낙)치료적료효.방법 수집HBeAg양성/음성만성을형간염환자,급여파라흔180 μg,매주일차,피하주사,료정48주이상,치료결속후수방26주.HBV DNA≥1×108고패/ml자연합NUC(아덕복위혹은체잡위).치료전ALT＞ 500 U/L혹파라흔치료제일침후ALT＞ 300 U/L자련용쌍배순25 mg,매일3차,치료1～2개월.치료전2 × ULN＜ ALT ＜300 U/L혹치료후ALT＜ 300 U/L자단용항병독치료.비교량조환자적치료응답화불량반응상황.결과총계54례환자(HBeAg양성44례,HBeAg음성10례)완성치료급수방,기중20례련용쌍배순(연합치료조),34례미련용쌍배순(대조조).결과 현시쌍배순연합치료조우치료후ALT수평축주하강,4주후유90％( 18/20)환자ALT＜ 200 U/L,대조조위85.3％ (29/34례).수방26주시량조ALT복상솔분별위80％(16/20)화85.3％ (29/34)；병독학응답솔상방,연합치료조교대조조HBsAg혈청학전환솔유명현증고(P =0.044),분별위30％ (6/20)화11.8％(4/34).결론 쌍배순가명현완해간우소치료유도적전안매승고반응,학보간우소치료순리진행,차불영향기항병독료효.
Objective To evaluate the effect of combination therapy with peginterferon alfa-2a (Pegasys) ±nucleos(t) ide analogues (NUC) and bicyclol in chronic hepatitis B with high ALT levels at baseline and during early treatment. Methods CHB patients were treated with PEG-IFNα-2a for a minimum of 48 weeks.All patients were followed up for 26 weeks post-treatment.Patients with HBV DNA ≥ 1 × 108 copies/ml were combined with NUC (adefovir or entecavir) treatment.Patients with ALT ＞ 500 U/L at baseline or ALT ＞ 300 U/L after first injection of PEG-IFNα-2a received bicyclol treatment for 1-2 months (treatment group).Patients with 2 × ULN ＜ ALT ＜ 300 U/L and ALT ＜ 300 U/L during treatment were enrolled into PEG-IFNα-2a ± NUC antiviral monotherapy (control group).Responses defined as HBV DNA ＜ 1 × 103 copies/ml,normal serum ALT,and HBeAg/HBsAg loss and seroconversion were analyzed at 26 weeks post-treatment.Results A total of 54 patients (44 HBeAg positive,10 HBeAg negative ) were divided into two groups according to combination of bieyclol:treatment group ( n =20 ) -those who received combinition therapy with PEG-IFNα-2a ± NUC and bicyclol,and control group (n =34 )-those who were treated with PEG-IFNα-2a ± NUC antiviral monotherapy.During the first month of treatment,ALT levels declined gradually in treatment group At 26 weeks post-treatment,the rates of ALT normalization and HBV DNA below the limit of 1 × 103 copies/ml were similar in both groups.Six patients in treatment group achieved HBsAg seroconversion at 26 weeks post-treatment,whereas so did 4 patients of control group(30％ vs.11.8％,P =0.044 ).Conclusion Bicyclol could significantly relief elevation of ALT induced by the IFN treatment.
