中华老年多器官疾病杂志
中華老年多器官疾病雜誌
중화노년다기관질병잡지
CHINESE JOURNAL OF MULTIPLE ORGAN DISEASES IN THE ELDERLY
2014年
12期
926-930
,共5页
乙型肝炎,慢性%老年人%干扰素
乙型肝炎,慢性%老年人%榦擾素
을형간염,만성%노년인%간우소
hepatitis B,chronic%aged%interferon
目的：探讨聚乙二醇干扰素α-2a（简称α-2a）在≥60岁老年乙型肝炎患者中抗病毒治疗的有效性和安全性。方法选取2009年4月至2013年4月武汉市医疗救治中心收治的62例老年慢性乙型病毒性肝炎患者为老年组，同期65例非老年患者为对照组。两组均接受α-2a 180μg，皮下注射，每周1次，治疗48周。结果老年人乙肝e抗原（HBeAg）阳性和HBeAg阴性组早期病毒学应答（4%，5.4%）低于对照组（25.92%，21.05%），HBeAg阳性患者持续病毒学应答（28.00%）低于对照组（55.56%），差异有统计学意义（P＜0.05）。老年组HBeAg转阴率[8（32.00%）]与对照组HBeAg转阴率[9（33.33%）]相比，差异无统计学意义（P＞0.05）。抑郁、心电图改变、白细胞计数下降不良反应发生率高于对照组（P＜0.05）。结论α-2a能够抑制HBeAg阳性和HBeAg阴性的老年乙肝患者体内乙肝病毒（HBV）-DNA复制，且能致HBeAg阳性患者血清学转阴。对于HBeAg阴性老年患者更易获得持续病毒学应答。治疗同时密切关注不良反应，及时干预。
目的：探討聚乙二醇榦擾素α-2a（簡稱α-2a）在≥60歲老年乙型肝炎患者中抗病毒治療的有效性和安全性。方法選取2009年4月至2013年4月武漢市醫療救治中心收治的62例老年慢性乙型病毒性肝炎患者為老年組，同期65例非老年患者為對照組。兩組均接受α-2a 180μg，皮下註射，每週1次，治療48週。結果老年人乙肝e抗原（HBeAg）暘性和HBeAg陰性組早期病毒學應答（4%，5.4%）低于對照組（25.92%，21.05%），HBeAg暘性患者持續病毒學應答（28.00%）低于對照組（55.56%），差異有統計學意義（P＜0.05）。老年組HBeAg轉陰率[8（32.00%）]與對照組HBeAg轉陰率[9（33.33%）]相比，差異無統計學意義（P＞0.05）。抑鬱、心電圖改變、白細胞計數下降不良反應髮生率高于對照組（P＜0.05）。結論α-2a能夠抑製HBeAg暘性和HBeAg陰性的老年乙肝患者體內乙肝病毒（HBV）-DNA複製，且能緻HBeAg暘性患者血清學轉陰。對于HBeAg陰性老年患者更易穫得持續病毒學應答。治療同時密切關註不良反應，及時榦預。
목적：탐토취을이순간우소α-2a（간칭α-2a）재≥60세노년을형간염환자중항병독치료적유효성화안전성。방법선취2009년4월지2013년4월무한시의료구치중심수치적62례노년만성을형병독성간염환자위노년조，동기65례비노년환자위대조조。량조균접수α-2a 180μg，피하주사，매주1차，치료48주。결과노년인을간e항원（HBeAg）양성화HBeAg음성조조기병독학응답（4%，5.4%）저우대조조（25.92%，21.05%），HBeAg양성환자지속병독학응답（28.00%）저우대조조（55.56%），차이유통계학의의（P＜0.05）。노년조HBeAg전음솔[8（32.00%）]여대조조HBeAg전음솔[9（33.33%）]상비，차이무통계학의의（P＞0.05）。억욱、심전도개변、백세포계수하강불량반응발생솔고우대조조（P＜0.05）。결론α-2a능구억제HBeAg양성화HBeAg음성적노년을간환자체내을간병독（HBV）-DNA복제，차능치HBeAg양성환자혈청학전음。대우HBeAg음성노년환자경역획득지속병독학응답。치료동시밀절관주불량반응，급시간예。
ObjectiveTo evaluate the efficacy and safety ofpeginterferon alpha-2a (α-2a) for the elderly patients with chronic hepatitis B (CHB).Methods A total of 62 elderly CHB patients (age>60 years) admitted in Wuhan Medical Treatment Center from April 2009 to April 2013 were recruited in this study and assigned into the elderly group. Another 65 CHB patients (age<60 years) admitted during the same period were subjected to the control group. All the groups received a subcutaneous injection ofα-2a at a dosage of 180 μg once per week for 48 consecutive weeks.Results The early virological responses (EVR) of HBeAg-positive and HBeAg-negative patients were significantly lower in the elderly group (4% and 5.4%) than in control group (25.92% and 21.05%), and so was the sustained virological response (SVR) in HBeAg-negative patients (28.00%vs 55.56%, P<0.05). The HBeAg seroconversion rate was 32.00%(8/25) in the elderly group and was 33.33%(9/27) in the control group, without significant difference between them (P>0.05). The incidence of main adverse effects, such as depression, ECG abnormalities and leucopenia, were significantly higher in the elderly group than in the control group (P<0.05).Conclusionα-2a suppresses the replication of hepatitis B virus DNA, and results in HBeAg seroconversion in HBeAg-positive and -negative elderlyCHB patients. It is more likely to achieve SVR to HBeAg-negative elderly patients. During the treatment, close attention should be paid to adverse reactions and timely intervention is necessary.
