中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2013年
7期
498-501
,共4页
曹振环%马丽娜%柳雅立%金怡%何智敏%鲁俊峰%张永宏%陈新月
曹振環%馬麗娜%柳雅立%金怡%何智敏%魯俊峰%張永宏%陳新月
조진배%마려나%류아립%금이%하지민%로준봉%장영굉%진신월
肝炎,乙型,慢性%肝炎e抗原,乙型%干扰素α-2a%阿德福韦酯%血清学转换
肝炎,乙型,慢性%肝炎e抗原,乙型%榦擾素α-2a%阿德福韋酯%血清學轉換
간염,을형,만성%간염e항원,을형%간우소α-2a%아덕복위지%혈청학전환
Hepatitis B,chronic%Hepatitis B e antigens%Interferon alfa-2a%Adefovir%Seroconversion
目的 探讨聚乙二醇干扰素(Peg-IFN) α-2a联合阿德福韦酯(ADV)治疗HBeAg阴性慢性乙型肝炎(CHB) 96周的疗效及安全性. 方法 25例初治HBeAg阴性CHB患者接受Peg-IFN α-2a(135μg/周或180μg/周)联合ADV (10 mg/d)治疗.96周治疗结束时,如获得HBsAg血清学转换则停药随访,否则停用Peg-IFN α-2a,继续ADV维持治疗.所有患者随访至120周.基线和治疗过程中每12周检测HBV DNA和HBsAg水平.计数资料采用x2检验或Fisher's exact test检验. 结果 Peg-IFNα-2a联合ADV治疗48周时,100％ (25/25)的患者HBV DNA低于检测值(＜ 500拷贝/ml),且在治疗过程中始终保持不可检测水平；治疗48周时HBsAg血清学转换率为12％ (3/25),96周上升至28％ (7/25).随访至120周,HBsAg血清学转换率为32％ (8/25).延长治疗至96周未见新的不良反应发生,其安全性同48周.结论 Peg-IFNα-2a联合ADV并延长疗程可显著提高HBeAg阴性CHB患者的抗病毒疗效,尤其可以提高HBsAg血清学转换率,是值得探索的优化治疗策略之一.
目的 探討聚乙二醇榦擾素(Peg-IFN) α-2a聯閤阿德福韋酯(ADV)治療HBeAg陰性慢性乙型肝炎(CHB) 96週的療效及安全性. 方法 25例初治HBeAg陰性CHB患者接受Peg-IFN α-2a(135μg/週或180μg/週)聯閤ADV (10 mg/d)治療.96週治療結束時,如穫得HBsAg血清學轉換則停藥隨訪,否則停用Peg-IFN α-2a,繼續ADV維持治療.所有患者隨訪至120週.基線和治療過程中每12週檢測HBV DNA和HBsAg水平.計數資料採用x2檢驗或Fisher's exact test檢驗. 結果 Peg-IFNα-2a聯閤ADV治療48週時,100％ (25/25)的患者HBV DNA低于檢測值(＜ 500拷貝/ml),且在治療過程中始終保持不可檢測水平；治療48週時HBsAg血清學轉換率為12％ (3/25),96週上升至28％ (7/25).隨訪至120週,HBsAg血清學轉換率為32％ (8/25).延長治療至96週未見新的不良反應髮生,其安全性同48週.結論 Peg-IFNα-2a聯閤ADV併延長療程可顯著提高HBeAg陰性CHB患者的抗病毒療效,尤其可以提高HBsAg血清學轉換率,是值得探索的優化治療策略之一.
목적 탐토취을이순간우소(Peg-IFN) α-2a연합아덕복위지(ADV)치료HBeAg음성만성을형간염(CHB) 96주적료효급안전성. 방법 25례초치HBeAg음성CHB환자접수Peg-IFN α-2a(135μg/주혹180μg/주)연합ADV (10 mg/d)치료.96주치료결속시,여획득HBsAg혈청학전환칙정약수방,부칙정용Peg-IFN α-2a,계속ADV유지치료.소유환자수방지120주.기선화치료과정중매12주검측HBV DNA화HBsAg수평.계수자료채용x2검험혹Fisher's exact test검험. 결과 Peg-IFNα-2a연합ADV치료48주시,100％ (25/25)적환자HBV DNA저우검측치(＜ 500고패/ml),차재치료과정중시종보지불가검측수평；치료48주시HBsAg혈청학전환솔위12％ (3/25),96주상승지28％ (7/25).수방지120주,HBsAg혈청학전환솔위32％ (8/25).연장치료지96주미견신적불량반응발생,기안전성동48주.결론 Peg-IFNα-2a연합ADV병연장료정가현저제고HBeAg음성CHB환자적항병독료효,우기가이제고HBsAg혈청학전환솔,시치득탐색적우화치료책략지일.
Objective To investigate the efficacy and safety of an extended course (96-week)of combination treatment with peginterferon alfa-2a (Peg-IFNαt-2a; 40 kd] plus adefovir (ADV) for treating chronic hepatitis B (CHB) in Chinese patients with negativity for hepatitis B e antigen (HBeAg).Methods A total of 25 consecutive patients with HBeAg-negative CHB were administered Peg-IFNα-2a (135-180 μg/week) plus ADV (10 mg/day) for 96 weeks.All patients were followed-up for 24 weeks after treatment completion.Levels of hepatitis B virus (HBV) DNA and hepatitis B surface antigen (HbsAg)were measured by fluorescence quantitative polymerase chain reaction (FQ-PCR) and chemiluminescent microparticle immunoassay,respectively,at 12-week intervals throughout the treatment course and at the end-of-follow-up (week 120).Patients underwent serological analysis at 3-6 month intervals during treatment and follow-up to evaluate occurrence of adverse events; serological parameters included blood count,markers of liver,kidney and thryoid function,and levels of autoantibodies and creatine kinase.Results For all patients,the 96-week course of Peg-IFNα-2a plus ADV reduced the level of HBV DNA below the detection threshold (＜ 500 copies/ml by FQ-PCR).The overall rate of HBsAg seroconversion was 12％ (3/25) at week 48,28％ (7/25) at week 96,and 32％ (8/25) at week 120.The occurrences of adverse events were similar at week 48 and week 96.Conclusion The extended-course Peg-IFNα-2a plus ADV combination therapy acheived a 100％ virological response and better rates of HBsAg seroconversion than 48 weeks of therapy,without a decrease in safety.
