CAJ | 학술논문

目的：评价脱氧核苷酸联合聚乙二醇化干扰素α-2a治疗慢性乙型肝炎(CHB﹚合并肝损伤的临床疗效的协同性。方法入选92例CHB合并肝损伤患者,治疗组46例给予PEG-IFNα-2a的同时联合脱氧核苷酸注射液200 mg/次静脉滴注。对照组46例仅给予PEG-IFNα-2a皮下注射,两组连续治疗48周后评估CHB血清标志物及肝功能指标。结果治疗组HBV-DNA阴转率(60.7% vs 39.2%﹚、HBeAg阴转率(34.8% vs 15.2%﹚、HBsAg阴转率(28.3% vs 10.8%﹚更高。治疗组ALT、AST、TBiL、ALP水平分别为(51.6±12.4﹚U/L、(51.8±12.8﹚U/L、(23.5±7.6﹚μmol/L、(87.2±24.2﹚U/L。对照组分别为(72.3±15.3﹚U/L、(70.8±13.4﹚U/L、(33.4±6.8﹚μmol/L、(158.4±28.7﹚U/L,即治疗组更低。另外治疗组血清总蛋白水平、血清白蛋白、A/G水平分别为(76.2±9.2﹚g/L、(37.5±8.3﹚g/L、(1.8±0.3﹚。对照组分别为(65.2±8.2﹚g/L、(32.3±7.9﹚g/L、(1.4±0.3﹚。两组具有明显的差异(P<0.05﹚。治疗过程中,治疗组白细胞减少发生率为6.5%,血小板减少发生率4.3%。对照组发生率则分别为26.1%、23.9%,两组比较具有统计学差异(P<0.05﹚。结论脱氧核苷酸联合PEG-IFNα-2a具有协同性,同时可减少干扰素的血液不良反应。
목적：평개탈양핵감산연합취을이순화간우소α-2a치료만성을형간염(CHB﹚합병간손상적림상료효적협동성。방법입선92례CHB합병간손상환자,치료조46례급여PEG-IFNα-2a적동시연합탈양핵감산주사액200 mg/차정맥적주。대조조46례부급여PEG-IFNα-2a피하주사,량조련속치료48주후평고CHB혈청표지물급간공능지표。결과치료조HBV-DNA음전솔(60.7% vs 39.2%﹚、HBeAg음전솔(34.8% vs 15.2%﹚、HBsAg음전솔(28.3% vs 10.8%﹚경고。치료조ALT、AST、TBiL、ALP수평분별위(51.6±12.4﹚U/L、(51.8±12.8﹚U/L、(23.5±7.6﹚μmol/L、(87.2±24.2﹚U/L。대조조분별위(72.3±15.3﹚U/L、(70.8±13.4﹚U/L、(33.4±6.8﹚μmol/L、(158.4±28.7﹚U/L,즉치료조경저。령외치료조혈청총단백수평、혈청백단백、A/G수평분별위(76.2±9.2﹚g/L、(37.5±8.3﹚g/L、(1.8±0.3﹚。대조조분별위(65.2±8.2﹚g/L、(32.3±7.9﹚g/L、(1.4±0.3﹚。량조구유명현적차이(P<0.05﹚。치료과정중,치료조백세포감소발생솔위6.5%,혈소판감소발생솔4.3%。대조조발생솔칙분별위26.1%、23.9%,량조비교구유통계학차이(P<0.05﹚。결론탈양핵감산연합PEG-IFNα-2a구유협동성,동시가감소간우소적혈액불량반응。
Objective To evaluate the clinical efficacy of deoxynucleotide combined with pegylated interferon α-2a in the treatment of chronic hepatitis B (CHB﹚ with liver injury. Methods All 92 cases of CHB with liver injury patients were selected in our clinical study. All patients were randomly divided into treatment group(n=46, treated with PEG-IFNα-2a and deoxynucleotide acid injection, 200 mg/d, intravenous drip﹚and control group (n=46, treated with PEG-IFNα-2a﹚.Then assessment of CHB serum markers and liver function after 48 weeks continuous treatment. Results There were significant differences between the two groups in the HBV-DNA negative rate (60.7% v s 39.2%﹚, the HBeAg se roconversion rate (34.8%vs 15.2%﹚, the HBsAg negative rate (28.3% vs 10.8%﹚, the ALT levels(51.6±12.4 vs 72.3± 15.3﹚U/L, the AST levels(51.8±12.8 vs 70.8±13.4﹚U/L, the TBiL levels(23.5±7.6 vs 33.4±6.8﹚μmol/L, the ALP lev-els(87.2±24.2 vs 158.4±28.7﹚U/L, the serum levels of total protein (76.2±9.2 vs 65.2±8.2﹚g/L, albumin (37.5±8.3 vs 32.3±7.9﹚g/L, and the A/G levels (1.8±0.3 vs 1.4±0.3﹚(P<0.05﹚. What’s more, during the course of treatment, the neutropenia rate(6.5%vs 26.1%﹚,thrombocytopenia incidence rate (4.3% vs 23.9%﹚also had significant difference be-tween the treatment group and control group (P<0.05﹚. Conclusion There is synergistic clinical efficacy of deoxynu-cleotide combined pegylated interferonα-2a, and less adverse events during treatment.