中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
2013年
2期
86-89
,共4页
肝炎,乙型,慢性%干扰素α%阿德福韦酯%联合治疗
肝炎,乙型,慢性%榦擾素α%阿德福韋酯%聯閤治療
간염,을형,만성%간우소α%아덕복위지%연합치료
Chronic hepatitis B%Interferon alpha%Adefovir dipivoxil%Combination therapy
目的 评估干扰素α (IFNα)联合阿德福韦酯(ADV)对IFNα单药治疗24周无应答慢性乙型肝炎(CHB)的疗效和安全性.方法 选择2009至2012年在厦门大学附属第一医院门诊及住院接受IFNα抗病毒治疗24周无应答的CHB患者60例.采用数字表法将病例随机分为3组,每组20例:实验组采用IFNα联合ADV治疗,对照组1继续使用IFNα治疗,对照组2停用IFNα改用ADV序贯治疗.比较三组患者的病毒学、血清学和生化学应答情况,并观察不良反应.应用SPSS 19.0统计软件进行数据分析.结果 治疗24周时,分别比较各组病例的HBV DNA载量、ALT水平、HBeAg滴度和HBsAg滴度,差异均无统计学意义(F=0.985,0.717,1.850和0.233,P＞0.05),且无病例发生HBeAg血清学转换.治疗48周时,实验组比对照组1有更高的HBV DNA转阴率、ALT复常率和HBeAg血清学转换率(x2=10.00,3.956和4.800,P＜0.05),但HBeAg转阴率比较差异无统计学意义(x2=0.693,P＞0.05)；实验组在HBV DNA转阴率、ALT复常率和HBeAg转阴率方面与对照组2比较差异无统计学意义(x2=1.026,1.905和0.156,P＞0.05),但HBeAg血清学转换率显著高于对照组2 (x2=4.800,P＜0.05)；所有病例均未发生HBsAg血清学转阴或转换,三组间HBsAg滴度差异无统计学意义(F=1.935,P＞0.05).未发现严重不良反应.结论 IFNα单药治疗24周无应答者联合ADV可获得较高的ALT复常率、HBeAg血清学转换率和HBV DNA阴转率,从总体上提高了CHB抗病毒的疗效.
目的 評估榦擾素α (IFNα)聯閤阿德福韋酯(ADV)對IFNα單藥治療24週無應答慢性乙型肝炎(CHB)的療效和安全性.方法 選擇2009至2012年在廈門大學附屬第一醫院門診及住院接受IFNα抗病毒治療24週無應答的CHB患者60例.採用數字錶法將病例隨機分為3組,每組20例:實驗組採用IFNα聯閤ADV治療,對照組1繼續使用IFNα治療,對照組2停用IFNα改用ADV序貫治療.比較三組患者的病毒學、血清學和生化學應答情況,併觀察不良反應.應用SPSS 19.0統計軟件進行數據分析.結果 治療24週時,分彆比較各組病例的HBV DNA載量、ALT水平、HBeAg滴度和HBsAg滴度,差異均無統計學意義(F=0.985,0.717,1.850和0.233,P＞0.05),且無病例髮生HBeAg血清學轉換.治療48週時,實驗組比對照組1有更高的HBV DNA轉陰率、ALT複常率和HBeAg血清學轉換率(x2=10.00,3.956和4.800,P＜0.05),但HBeAg轉陰率比較差異無統計學意義(x2=0.693,P＞0.05)；實驗組在HBV DNA轉陰率、ALT複常率和HBeAg轉陰率方麵與對照組2比較差異無統計學意義(x2=1.026,1.905和0.156,P＞0.05),但HBeAg血清學轉換率顯著高于對照組2 (x2=4.800,P＜0.05)；所有病例均未髮生HBsAg血清學轉陰或轉換,三組間HBsAg滴度差異無統計學意義(F=1.935,P＞0.05).未髮現嚴重不良反應.結論 IFNα單藥治療24週無應答者聯閤ADV可穫得較高的ALT複常率、HBeAg血清學轉換率和HBV DNA陰轉率,從總體上提高瞭CHB抗病毒的療效.
목적 평고간우소α (IFNα)연합아덕복위지(ADV)대IFNα단약치료24주무응답만성을형간염(CHB)적료효화안전성.방법 선택2009지2012년재하문대학부속제일의원문진급주원접수IFNα항병독치료24주무응답적CHB환자60례.채용수자표법장병례수궤분위3조,매조20례:실험조채용IFNα연합ADV치료,대조조1계속사용IFNα치료,대조조2정용IFNα개용ADV서관치료.비교삼조환자적병독학、혈청학화생화학응답정황,병관찰불량반응.응용SPSS 19.0통계연건진행수거분석.결과 치료24주시,분별비교각조병례적HBV DNA재량、ALT수평、HBeAg적도화HBsAg적도,차이균무통계학의의(F=0.985,0.717,1.850화0.233,P＞0.05),차무병례발생HBeAg혈청학전환.치료48주시,실험조비대조조1유경고적HBV DNA전음솔、ALT복상솔화HBeAg혈청학전환솔(x2=10.00,3.956화4.800,P＜0.05),단HBeAg전음솔비교차이무통계학의의(x2=0.693,P＞0.05)；실험조재HBV DNA전음솔、ALT복상솔화HBeAg전음솔방면여대조조2비교차이무통계학의의(x2=1.026,1.905화0.156,P＞0.05),단HBeAg혈청학전환솔현저고우대조조2 (x2=4.800,P＜0.05)；소유병례균미발생HBsAg혈청학전음혹전환,삼조간HBsAg적도차이무통계학의의(F=1.935,P＞0.05).미발현엄중불량반응.결론 IFNα단약치료24주무응답자연합ADV가획득교고적ALT복상솔、HBeAg혈청학전환솔화HBV DNA음전솔,종총체상제고료CHB항병독적료효.
Objective To evaluate the efficacy and safety of interferon alpha (IFNα) combined with adefovir dipivoxil (ADV) for patients with chronic hepatitis B (CHB) non-responding to 24-week IFNα monotherapy.Methods Sixty CHB patients admitted to the First Affiliated Hospital of Xiamen University during 2009 and 2012 were enrolled in the study.All patients recieved IFNα monotherapy for 24 weeks and had no response.The patients were randomly divided into 3 groups by number table with 20 cases in each group.The experimental group was treated with IFNα combined with ADV,the control group 1 continued IFNα monotherapy,and the control group 2 shifted to ADV monotherapy.Virological,serological and biochemical responses were compared,and adverse reactions were observed.SPSS 19.0 software was used for data analysis.Results After 24 weeks of treatment,there was no statistical difference in HBV DNA loads,ALT levels and titers of HBeAg and HBsAg among three groups (F =0.985,0.717,0.985 and 0.717,P ＞ 0.05).And no HBeAg seroconversion was observed.After 48 weeks of treatment,the experimental group had higher HBV DNA negative conversion rate,ALT normalization rate and HBeAg conversion rate than control group 1 (x2 =10.00,3.956 and 4.800,P ＜ 0.05),but no statistically significant difference was found in HBeAg negative conversion rate (x2 =0.693,P ＞ 0.05).There was no significant difference in HBV DNA and HBeAg negative conversion rates between experimental group and the control group 2 (x2 =1.026,1.905 and 0.156,P ＞0.05),but the HBeAg conversion rate in experimental group was significantly higher than that in control group 2 (x2 =4.800,P ＜ 0.05).No HBsAg negative or serological conversion was observed,and there was no significant difference in titers of HBsAg among three groups (F =1.935,P ＞ 0.05).No adverse reaction was observed.Conclusion For patients nonresponding to IFNα monotherapy,combination of IFNα and ADV can achieve higher ALT normalization rate,HBeAg conversion rate and HBV DNA negative conversion rate,and improve the overall efficacy of CHB antiviral therapy.
