中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2015年
12期
1-2,3
,共3页
万裴奇%李则平%薛云贵%李子方
萬裴奇%李則平%薛雲貴%李子方
만배기%리칙평%설운귀%리자방
脱氧核苷酸%病毒性肝炎%肝功能异常
脫氧覈苷痠%病毒性肝炎%肝功能異常
탈양핵감산%병독성간염%간공능이상
Deoxynucleotide%Viral hepatitis%Abnormal liver function
目的：观察脱氧核苷酸联合聚乙二醇化干扰素α-2a(PEG-IFNα-2a)治疗慢性乙型病毒性肝炎(CHB)合并肝功能异常的临床疗效与安全性。方法84例CHB合并肝功能异常患者，随机分为治疗组42例，给予PEG-IFNα-2a联合脱氧核苷酸注射液治疗，对照组42例仅给予PEG-IFNα-2a治疗，两组连续治疗24周后评估疗效。结果治疗组乙肝病毒脱氧核糖核酸(HBV-DNA)阴转率(66.7% VS 42.9%)，乙肝e抗原(HBeAg)阴转率(45.2% VS 19.0%)，乙肝s抗原(HBsAg)阴转率(35.7% VS 16.7%)， HBeAg/抗-HBe血清学转换率(35.7% VS 14.3%)， HBsAg/抗-HBs血清学转换率(19.0% VS 2.4%)均高于对照组(P<0.05)。治疗组谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBiL)、碱性磷酸酶(ALP)、血清总蛋白(TP)、血清白蛋白(ALB)水平与对照组比较，差异均具有统计学意义(P<0.05)。治疗组白细胞减少发生率为7.1%(3/42)，血小板减少发生率4.8%(2/42)。对照组发生率则分别为28.6%(12/42)、23.8%(10/42)。两组比较，差异具有统计学意义(P<0.05)。结论脱氧核苷酸联合聚乙二醇化干扰素α-2a可提高CHB治疗的转阴率，减少干扰素的骨髓抑制、肝损伤等不良反应。
目的：觀察脫氧覈苷痠聯閤聚乙二醇化榦擾素α-2a(PEG-IFNα-2a)治療慢性乙型病毒性肝炎(CHB)閤併肝功能異常的臨床療效與安全性。方法84例CHB閤併肝功能異常患者，隨機分為治療組42例，給予PEG-IFNα-2a聯閤脫氧覈苷痠註射液治療，對照組42例僅給予PEG-IFNα-2a治療，兩組連續治療24週後評估療效。結果治療組乙肝病毒脫氧覈糖覈痠(HBV-DNA)陰轉率(66.7% VS 42.9%)，乙肝e抗原(HBeAg)陰轉率(45.2% VS 19.0%)，乙肝s抗原(HBsAg)陰轉率(35.7% VS 16.7%)， HBeAg/抗-HBe血清學轉換率(35.7% VS 14.3%)， HBsAg/抗-HBs血清學轉換率(19.0% VS 2.4%)均高于對照組(P<0.05)。治療組穀丙轉氨酶(ALT)、穀草轉氨酶(AST)、總膽紅素(TBiL)、堿性燐痠酶(ALP)、血清總蛋白(TP)、血清白蛋白(ALB)水平與對照組比較，差異均具有統計學意義(P<0.05)。治療組白細胞減少髮生率為7.1%(3/42)，血小闆減少髮生率4.8%(2/42)。對照組髮生率則分彆為28.6%(12/42)、23.8%(10/42)。兩組比較，差異具有統計學意義(P<0.05)。結論脫氧覈苷痠聯閤聚乙二醇化榦擾素α-2a可提高CHB治療的轉陰率，減少榦擾素的骨髓抑製、肝損傷等不良反應。
목적：관찰탈양핵감산연합취을이순화간우소α-2a(PEG-IFNα-2a)치료만성을형병독성간염(CHB)합병간공능이상적림상료효여안전성。방법84례CHB합병간공능이상환자，수궤분위치료조42례，급여PEG-IFNα-2a연합탈양핵감산주사액치료，대조조42례부급여PEG-IFNα-2a치료，량조련속치료24주후평고료효。결과치료조을간병독탈양핵당핵산(HBV-DNA)음전솔(66.7% VS 42.9%)，을간e항원(HBeAg)음전솔(45.2% VS 19.0%)，을간s항원(HBsAg)음전솔(35.7% VS 16.7%)， HBeAg/항-HBe혈청학전환솔(35.7% VS 14.3%)， HBsAg/항-HBs혈청학전환솔(19.0% VS 2.4%)균고우대조조(P<0.05)。치료조곡병전안매(ALT)、곡초전안매(AST)、총담홍소(TBiL)、감성린산매(ALP)、혈청총단백(TP)、혈청백단백(ALB)수평여대조조비교，차이균구유통계학의의(P<0.05)。치료조백세포감소발생솔위7.1%(3/42)，혈소판감소발생솔4.8%(2/42)。대조조발생솔칙분별위28.6%(12/42)、23.8%(10/42)。량조비교，차이구유통계학의의(P<0.05)。결론탈양핵감산연합취을이순화간우소α-2a가제고CHB치료적전음솔，감소간우소적골수억제、간손상등불량반응。
Objective To observe the clinical effect and safety of deoxynucleotide combined with pegylated interferon α-2a(PEG-IFNα-2a)in the treatment of chronic viral hepatitis B (CHB) complicated with abnormal liver function.Methods A total of 84 patients of CHB complicated with liver injury were randomly divided into treatment group with 42 cases, receiving PEG-IFN α-2a combined with deoxynucleotide injection for treatment, and control group with 42 cases receiving PEG-IFN α-2a alone. After 24 weeks of treatment, curative effects of the two groups were evaluated. Results The treatment group had higher hepatitis B virus-deoxyribonucleic acid (HBV-DNA) negative rate (66.7% VS 42.9%), hepatitis Be antigen (HBeAg) negative rate (45.2% VS 19.1%), hepatitis B surface antigen (HBsAg) negative rate (35.7% VS 16.7%), HBeAg/anti-HBeserologic negative rate (35.7% VS 14.3%), andHBsAg/anti-HBs serologic negative rate (19.0% VS 2.4%) than the control group (P<0.05). The treatment group had statistically significant differnces of alanine aminotransferase (ALT), aspartate transaminase (AST), total bilirubin (TBiL), alkaline phosphatase (ALP), total serum protein (TP), and serum albumin (ALB), compared with the control group (P<0.05). The incidence of leucopenia was 7.1% (3/42), and incidence of thrombocytopenia was 4.8% (2/42) in the treatment group. Those in the control group were respectively 28.6% (12/42) and 23.8% (10/42). The difference between the two groups had statistical significance (P<0.05).Conclusion Combination of deoxynucleotide and pegylated interferon α-2a can improve the negative rate in treatment for CHB, and reduce myelosuppression of interferon and adverse reactions as liver injury.
