国际流行病学传染病学杂志
國際流行病學傳染病學雜誌
국제류행병학전염병학잡지
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY AND INFECTIOUS DISEASE
2010年
4期
251-253
,共3页
肝炎,乙型,慢性%干扰素α%阿德福韦
肝炎,乙型,慢性%榦擾素α%阿德福韋
간염,을형,만성%간우소α%아덕복위
Hepatitis B,ehronic%Interferon-α%Adefovir
目的 评价阿德福韦治疗经IFN-α治疗12周无应答的慢性乙型肝炎患者的疗效和安全性.方法 36例经IFN-α治疗12周,复查HBeAg仍阳性且HBV DNA＞5log10拷贝/mL的患者,按随机双盲的方法,分为治疗组和对照组各18例.治疗组给予阿德福韦,对照组继续给予IFN-α,治疗52周.结果 治疗52周末,治疗组与对照组HBV DNA载量比较差异有统计学意义(χ2=3.04,P＜0.01);HBV DNA载量下降超过2 log10拷贝/mL的患者比较,两组差异有统计学意义(χ2=11.10,P＜0.01).治疗组HBeAg阴转率为22.22%,HBeAg/抗-HBe血清转换率为11.11%,与对照组的27.78%和16.67%相比,差异均无统计学意义.治疗组ALT复常率为88.89%,对照组为61.11%(P＜0.05).HBV DNA＜5log10拷贝/mL的患者停药24周反跳率治疗组为25.00%,对照组为16.67%.结论 继以阿德福韦序贯治疗经IFN-α治疗12周无应答的慢性乙型肝炎患者,能有效抑制其病毒复制,但HBeAg/抗-HBe的血清转换率变化不明显.试验52周内阿德福韦使用安全且耐受性良好,但阿德福韦的治疗终点仍有待研究.
目的 評價阿德福韋治療經IFN-α治療12週無應答的慢性乙型肝炎患者的療效和安全性.方法 36例經IFN-α治療12週,複查HBeAg仍暘性且HBV DNA＞5log10拷貝/mL的患者,按隨機雙盲的方法,分為治療組和對照組各18例.治療組給予阿德福韋,對照組繼續給予IFN-α,治療52週.結果 治療52週末,治療組與對照組HBV DNA載量比較差異有統計學意義(χ2=3.04,P＜0.01);HBV DNA載量下降超過2 log10拷貝/mL的患者比較,兩組差異有統計學意義(χ2=11.10,P＜0.01).治療組HBeAg陰轉率為22.22%,HBeAg/抗-HBe血清轉換率為11.11%,與對照組的27.78%和16.67%相比,差異均無統計學意義.治療組ALT複常率為88.89%,對照組為61.11%(P＜0.05).HBV DNA＜5log10拷貝/mL的患者停藥24週反跳率治療組為25.00%,對照組為16.67%.結論 繼以阿德福韋序貫治療經IFN-α治療12週無應答的慢性乙型肝炎患者,能有效抑製其病毒複製,但HBeAg/抗-HBe的血清轉換率變化不明顯.試驗52週內阿德福韋使用安全且耐受性良好,但阿德福韋的治療終點仍有待研究.
목적 평개아덕복위치료경IFN-α치료12주무응답적만성을형간염환자적료효화안전성.방법 36례경IFN-α치료12주,복사HBeAg잉양성차HBV DNA＞5log10고패/mL적환자,안수궤쌍맹적방법,분위치료조화대조조각18례.치료조급여아덕복위,대조조계속급여IFN-α,치료52주.결과 치료52주말,치료조여대조조HBV DNA재량비교차이유통계학의의(χ2=3.04,P＜0.01);HBV DNA재량하강초과2 log10고패/mL적환자비교,량조차이유통계학의의(χ2=11.10,P＜0.01).치료조HBeAg음전솔위22.22%,HBeAg/항-HBe혈청전환솔위11.11%,여대조조적27.78%화16.67%상비,차이균무통계학의의.치료조ALT복상솔위88.89%,대조조위61.11%(P＜0.05).HBV DNA＜5log10고패/mL적환자정약24주반도솔치료조위25.00%,대조조위16.67%.결론 계이아덕복위서관치료경IFN-α치료12주무응답적만성을형간염환자,능유효억제기병독복제,단HBeAg/항-HBe적혈청전환솔변화불명현.시험52주내아덕복위사용안전차내수성량호,단아덕복위적치료종점잉유대연구.
Objective To evaluate the efficacy and safety of adefovir (ADV) in the treatment of chronic hepatitis B patients with no response to 12 weeks treatment of interferon-α. Methods After 12 weeks treatment of interferon-α, 36chronic hepatitis B patients with HBeAg positive or HBV DNA ＞ 5log10 copies/mL were randomly assigned as treatment group and control group. 18 patients in treatment group were accepted ADV, and other 18 patients in control group continued to accept intefferon-α for 52 weeks. Results At the end of 52 weeks, HBV DNA levels in treatment group reduced obviously compared to control group( χ2 = 3.04, P ＜ 0.01 ); the ratio of patients whose HBV DNA levels reduced above 2 log in treatment group was also obviously compared to control group( χ2 = 11.10, P ＜ 0.01 ). In treatment group, the negative ratio of HBeAg was 22.22%, and the ratio of HBeAg seroconversion was 11. 11%, in control group both rates were 27.78% and 16.67% respectively, and there was no difference between the two groups. In treatment group, 88.89% of patients achieved ALT normalization, and in control group achieved 61.11% ( P ＜0.05). After 24weeks, the rebound rate of patients with HBV DNA ＜ 5log10 copies/mL at the end of treatment was 25.00% in tteatment group, and 16.67% in control group. Conclusions ADV can restrain the repliication of HBV in patients who have no response to 12 weeks treatment of interferon-α, but its effect on HBeAg seroconversion is not obvious. ADV is safe in the 52 weeks of treatment, but the end of the treatment is remaining further study.
