中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2008年
4期
240-243
,共4页
毛乾国%骆抗先%刘定立%傅群芳%冯筱榕%郭亚兵%朱幼芙%彭劫%侯金林
毛乾國%駱抗先%劉定立%傅群芳%馮篠榕%郭亞兵%硃幼芙%彭劫%侯金林
모건국%락항선%류정립%부군방%풍소용%곽아병%주유부%팽겁%후금림
肝炎,乙型,慢性%干扰素α%肝炎e抗原,乙型%随访研究
肝炎,乙型,慢性%榦擾素α%肝炎e抗原,乙型%隨訪研究
간염,을형,만성%간우소α%간염e항원,을형%수방연구
Hepatitis B,chronic%Interferon-alpha%HBeAg%Follow-up studies 361009)
目的 了解IFN-α个体化治疗HBeAg阴性慢性乙型肝炎(CHB)患者的疗效.方法 经肝组织穿刺活检证实的HBeAg阴性CHB患者76例,给予IFN-α1b治疗,每次5 MU,每周3次.治疗结束后随访至少24个月.联合应答定义为血清ALT复常,且HBV DNA<3 loglo拷贝/mL.所有资料均行意向性分析(ITT).结果 脱落6例.疗程中位数为8.5(2～24)个月,终点疗程中位数为6.0(2～19)个月,终点疗程第75百分位数为10.0个月.治疗末时联合应答率为46.1%(35/76),随访12个月时为43.3%(33/76),随访24个月时为40.8%(31/76).随访12个月时复发率为20.0%(7/35),随访24个月时为25.7%(9/35).多变量二分类Logistic分析显示,肝组织炎性活动度较高者较易应答(偏回归系数=0.834,P=0.023,OR=2.303,95%可信区间为:1.120,4.735),而性别、年龄、肝组织纤维化程度、ALT、AST、HBV DNA载量等为非疗效影响因素.结论 IFN-α个体化治疗HBeAg阴性CHB患者有一定的持续效应.
目的 瞭解IFN-α箇體化治療HBeAg陰性慢性乙型肝炎(CHB)患者的療效.方法 經肝組織穿刺活檢證實的HBeAg陰性CHB患者76例,給予IFN-α1b治療,每次5 MU,每週3次.治療結束後隨訪至少24箇月.聯閤應答定義為血清ALT複常,且HBV DNA<3 loglo拷貝/mL.所有資料均行意嚮性分析(ITT).結果 脫落6例.療程中位數為8.5(2～24)箇月,終點療程中位數為6.0(2～19)箇月,終點療程第75百分位數為10.0箇月.治療末時聯閤應答率為46.1%(35/76),隨訪12箇月時為43.3%(33/76),隨訪24箇月時為40.8%(31/76).隨訪12箇月時複髮率為20.0%(7/35),隨訪24箇月時為25.7%(9/35).多變量二分類Logistic分析顯示,肝組織炎性活動度較高者較易應答(偏迴歸繫數=0.834,P=0.023,OR=2.303,95%可信區間為:1.120,4.735),而性彆、年齡、肝組織纖維化程度、ALT、AST、HBV DNA載量等為非療效影響因素.結論 IFN-α箇體化治療HBeAg陰性CHB患者有一定的持續效應.
목적 료해IFN-α개체화치료HBeAg음성만성을형간염(CHB)환자적료효.방법 경간조직천자활검증실적HBeAg음성CHB환자76례,급여IFN-α1b치료,매차5 MU,매주3차.치료결속후수방지소24개월.연합응답정의위혈청ALT복상,차HBV DNA<3 loglo고패/mL.소유자료균행의향성분석(ITT).결과 탈락6례.료정중위수위8.5(2～24)개월,종점료정중위수위6.0(2～19)개월,종점료정제75백분위수위10.0개월.치료말시연합응답솔위46.1%(35/76),수방12개월시위43.3%(33/76),수방24개월시위40.8%(31/76).수방12개월시복발솔위20.0%(7/35),수방24개월시위25.7%(9/35).다변량이분류Logistic분석현시,간조직염성활동도교고자교역응답(편회귀계수=0.834,P=0.023,OR=2.303,95%가신구간위:1.120,4.735),이성별、년령、간조직섬유화정도、ALT、AST、HBV DNA재량등위비료효영향인소.결론 IFN-α개체화치료HBeAg음성CHB환자유일정적지속효응.
Objective To investigate the efficacy of individualized interferon (IFN)-alpha therapy in HBeAg-negative chronic hepatitis B patients. Methods Seventy- six Chinese HBeAg-negative chronic hepatitis B patients proven by liver biopsy were treated with 5 MU recombinant IFN-alpha 1b subcutaneously thrice every week. All the patients were followed up for at least 24 months the combined responses were defined as normalization of serum alanine transaminase (ALT) and HBV DNA＜3 log10 copy/mL. An intention-to-treat (ITT) analysis was used in this paper in which all 76 patients were included. Results Six patients were lost. Treatment duration was in the range 2-24 months with a median of 8.5 months, and combined responses were achieved at a median of 6.0 months (range 2-19 months) of treatment duration.Seventy-five-percentile of treatment duration to endpoints was 10.0 months. The combined response rate was 46.1% (35/76) at the end of treatment, 43.3% (33/76) at 12-month follow-up and 40.8% (31/76) at 24-month follow-up. The relapse rate was 20. 0% (7/35) and 25. 7% (9/35) at 12-month and 24-month follow-up, respectively. Higher necroinflammatory activity in liver biopsy predicted a good response, while gender, age, liver fibrosis, baseline ALT, aspartate aminotransferase levels and baseline HBV DNA levels were not impact factors of therapeutic effects by binary Logistic regression analysis.Conclusion Individualized prolonged IFN-alpha regimen lead to considerable sustained disease suppression in patients with HBeAg-negative chronic hepatitis B.
