CAJ | 학술논문

目的探讨IFNα联合甘露聚糖肽治疗HBeAg阳性慢性乙型肝炎(CHB)的临床效果.方法选择80例HBeAg阳性CHB患者,随机分为治疗组和对照组,各40例,HBV DNA载量为103～108拷贝/mL.治疗组用IFNα-2b 500万U/次,皮下注射,疗程52周;甘露聚糖肽10 mg/次静脉滴注或2.5 mg/次肌肉沣射,12周为1个疗程,共2～3个疗程.对照组单用IFNα-2b.2组分别于治疗前、治疗后第2、4、8、16、26和第52周检测盯功能、HBV血清学标志物、HBV DNA定量、血常规等,记录不良反应.结果 52周时,治疗绀的ALT复常率、HBsAg转阴率、HBeAg转阴率、HBeAg转换率和HBVDNA转阴率分别为91.8%、17.5%、52.5%、27.5%和47.5%,而对照组分别为80.0%、12.5%、30.0%、10.0%和25.0%,2组后3项指标比较差异有统计学意义(X2=4.178、4.021、4.381,P值均＜0.05).停药52周后复查.治疗组HBeAg转阴率、HBeAg转换率和HBV DNA转阴率分别为57.5%、30.0%和50.0%,较停药时有不同程度的提升.治疗组用药4周后WBC开始回升,第8周时基本接近正常水平;而对照组在52周疗程结束时的WBC计数为(3.45±1.18)×109/L,仍然低于正常值.结论甘露聚糖肽联合IFNα治疗HBeAg阳性CHB可显著提高患者的疗效,并可缓解干扰素治疗导致的外周血白细胞减少,增强患者的治疗依从性.
목적 탐토IFNα연합감로취당태치료HBeAg양성만성을형간염(CHB)적림상효과.방법 선택80례HBeAg양성CHB환자,수궤분위치료조화대조조,각40례,HBV DNA재량위103～108고패/mL.치료조용IFNα-2b 500만U/차,피하주사,료정52주;감로취당태10 mg/차정맥적주혹2.5 mg/차기육풍사,12주위1개료정,공2～3개료정.대조조단용IFNα-2b.2조분별우치료전、치료후제2、4、8、16、26화제52주검측정공능、HBV혈청학표지물、HBV DNA정량、혈상규등,기록불량반응.결과 52주시,치료감적ALT복상솔、HBsAg전음솔、HBeAg전음솔、HBeAg전환솔화HBVDNA전음솔분별위91.8%、17.5%、52.5%、27.5%화47.5%,이대조조분별위80.0%、12.5%、30.0%、10.0%화25.0%,2조후3항지표비교차이유통계학의의(X2=4.178、4.021、4.381,P치균＜0.05).정약52주후복사.치료조HBeAg전음솔、HBeAg전환솔화HBV DNA전음솔분별위57.5%、30.0%화50.0%,교정약시유불동정도적제승.치료조용약4주후WBC개시회승,제8주시기본접근정상수평;이대조조재52주료정결속시적WBC계수위(3.45±1.18)×109/L,잉연저우정상치.결론 감로취당태연합IFNα치료HBeAg양성CHB가현저제고환자적료효,병가완해간우소치료도치적외주혈백세포감소,증강환자적치료의종성.
Objective To investigate the clinical effect of IFNα combined with mannan peptide in treatment of patients with HBeAg-positive chronic hepatitis B ( CHB ). Methods Eighty HBeAg-positive CHB patients with HBV DNA quantity ranging from 10 to 10 eopies/mL were enrolled and randomized into the treatment group and the control group ( n = 40 for each ). Patients in treatment group were given daily subcutaneous injection of IFNα-2b 5,000,000 U for 52 weeks, and received mannan peptide 10 mg per intravenous injection or 2. 5 mg per intramuscular injection for a total of 2 to 3 treatment courses (12 weeks for each). The control group received only IFNα-2b treatment. Liver function, serum markers of hepatitis B, HBV DNA quantity and blood tests were performed before the treatment and at 2, 4, 8, 16, 26 and 52-week during the treatment; and the adverse effects were recorded. Results The rates for ALT normalization, negative HBsAg, negative HBeAg, HBeAg seroconversion and negative HBV DNA were 91. 8% , 17. 5% , 52. 5% , 27. 5 % and 47. 5% at 52nd week in the treatment group, while those in the control group were 80. 0% , 12. 5% , 30. 0% , 10. 0 % and 25. 0% , respectively. There were significant differences in HBeAg-negative, HBeAg-seroeonversion and HBV DNA-negative rates between two groups (χ2 = 4. 178, 4.021 and 4.381, P < 0. 05 ) , and these indexes in the treatment group were increased to 57. 5% , 30. 0% and 50. 0 respectively at 52nd week after drug withdraw. White blood cells began to be elevated at 4th week and were restored to the normal levels at 8th week in the treatment group, while the count in the control was lower than the normal value even at 52nd week of the treatment with the average of (3.45±1. 18)×109/L. Conclusion Alpha-interferon combined with mannan peptide therapy is effective for patients with HBeAg-positive CHB, which may restore the declined peripheral WBC counts induced by interferon and improve the compliance.