广西医学
廣西醫學
엄서의학
GUANGXI MEDICAL JOURNAL
2015年
4期
473-475
,共3页
安红杰%何文艳%徐金凤%赵崇山
安紅傑%何文豔%徐金鳳%趙崇山
안홍걸%하문염%서금봉%조숭산
慢性乙型肝炎%聚乙二醇干扰素α-2a%阿德福韦酯%HBsAg%HBeAg%血清转换率
慢性乙型肝炎%聚乙二醇榦擾素α-2a%阿德福韋酯%HBsAg%HBeAg%血清轉換率
만성을형간염%취을이순간우소α-2a%아덕복위지%HBsAg%HBeAg%혈청전환솔
Chronic hepatitic B%Pegylated interferonα-2a%Adefovir dipivoxil%HBsAg%HBeAg%Seroconversion rate
目的：观察阿德福韦酯（ADV）降低HBV-DNA载量后再联合聚乙二醇干扰素α-2a（pegIFNα-2a）治疗HBeAg阳性慢性乙型肝炎的疗效。方法60例HBV-DNA≥1．0×107 IU／ml的HBeAg阳性慢性乙型肝炎患者，随机分为两组：A组30例，治疗开始即口服ADV 10 mg，1次／d，并给予皮下注射pegIFNα-2a，180μg每周1次；B组30例，治疗开始即口服ADV 10 mg，1次／d，当1．0×103 IU／ml＜HBV-DNA≤1．0×104 IU／ml时给予pegIFNα-2a 180μg，每周1次。两组疗程均48周。对比两组HBsAg阴转率及其血清学转换率、HBeAg血清转换率，HBV-DNA阴转率及ALT复常率的差异。结果治疗48周时，B组HBsAg阴转率为24．1％（7／29）稍高于A组的10．7％（3／28），B组HBsAg血清转换率为20．7％（6／29）稍高于A组的7．1％（2／28），但差异无统计学意义（P＞0．05）；B组患者HBeAg血清转换率为62．1％（18／29）显著高于A组患者的35．7％（10／28）（P＜0．05）；A、B两组患者ALT复常率、HBV-DNA阴转率，差异无统计学意义（P＞0．05）。结论 ADV治疗HBV-DNA载量下降后联合pegIFNα-2a治疗能够提高慢性乙型肝炎患者的HBeAg血清转换率，对HBsAg阴转率及其血清转换率也有益。
目的：觀察阿德福韋酯（ADV）降低HBV-DNA載量後再聯閤聚乙二醇榦擾素α-2a（pegIFNα-2a）治療HBeAg暘性慢性乙型肝炎的療效。方法60例HBV-DNA≥1．0×107 IU／ml的HBeAg暘性慢性乙型肝炎患者，隨機分為兩組：A組30例，治療開始即口服ADV 10 mg，1次／d，併給予皮下註射pegIFNα-2a，180μg每週1次；B組30例，治療開始即口服ADV 10 mg，1次／d，噹1．0×103 IU／ml＜HBV-DNA≤1．0×104 IU／ml時給予pegIFNα-2a 180μg，每週1次。兩組療程均48週。對比兩組HBsAg陰轉率及其血清學轉換率、HBeAg血清轉換率，HBV-DNA陰轉率及ALT複常率的差異。結果治療48週時，B組HBsAg陰轉率為24．1％（7／29）稍高于A組的10．7％（3／28），B組HBsAg血清轉換率為20．7％（6／29）稍高于A組的7．1％（2／28），但差異無統計學意義（P＞0．05）；B組患者HBeAg血清轉換率為62．1％（18／29）顯著高于A組患者的35．7％（10／28）（P＜0．05）；A、B兩組患者ALT複常率、HBV-DNA陰轉率，差異無統計學意義（P＞0．05）。結論 ADV治療HBV-DNA載量下降後聯閤pegIFNα-2a治療能夠提高慢性乙型肝炎患者的HBeAg血清轉換率，對HBsAg陰轉率及其血清轉換率也有益。
목적：관찰아덕복위지（ADV）강저HBV-DNA재량후재연합취을이순간우소α-2a（pegIFNα-2a）치료HBeAg양성만성을형간염적료효。방법60례HBV-DNA≥1．0×107 IU／ml적HBeAg양성만성을형간염환자，수궤분위량조：A조30례，치료개시즉구복ADV 10 mg，1차／d，병급여피하주사pegIFNα-2a，180μg매주1차；B조30례，치료개시즉구복ADV 10 mg，1차／d，당1．0×103 IU／ml＜HBV-DNA≤1．0×104 IU／ml시급여pegIFNα-2a 180μg，매주1차。량조료정균48주。대비량조HBsAg음전솔급기혈청학전환솔、HBeAg혈청전환솔，HBV-DNA음전솔급ALT복상솔적차이。결과치료48주시，B조HBsAg음전솔위24．1％（7／29）초고우A조적10．7％（3／28），B조HBsAg혈청전환솔위20．7％（6／29）초고우A조적7．1％（2／28），단차이무통계학의의（P＞0．05）；B조환자HBeAg혈청전환솔위62．1％（18／29）현저고우A조환자적35．7％（10／28）（P＜0．05）；A、B량조환자ALT복상솔、HBV-DNA음전솔，차이무통계학의의（P＞0．05）。결론 ADV치료HBV-DNA재량하강후연합pegIFNα-2a치료능구제고만성을형간염환자적HBeAg혈청전환솔，대HBsAg음전솔급기혈청전환솔야유익。
Objective To observe the efficacy of adefovir dipivoxil combined with pegylated interferon α-2a(pegIFNα-2a) after adefovir dipivoxil( ADV) reducing HBV-DNA load in the treatment of HBeAg-positive patients with chronic hepatitis B.Methods Sixty HBeAg-positive chronic hepatitis B patients with HBV-DNA>or =1.0 ×107 IU/ml were randomly divided into two groups.Thirty cases in Group A were orally given 10 mg of ADV once a day as well as subcutaneous injection of 180 μg of pegIFNα-2a once a week.Thirty cases in Group B were orally given 10 mg of ADV once a day at first,and then were given 180 μg of pegIFNα-2a once a week when HBV-DNA>1.0 ×103 IU/ml and <1.0 ×104 IU/ml.The treatment lasted for 48 weeks in both groups.The negative rate of HBsAg, seroconversion rate of HBsAg,seroconversion rate of HBeAg,negative rate of HBV-DNA and recovery rate of ALT were compared between two groups.Results In the 48th week of treatment,the negative rate of HBsAg in Group B was slightly higher than that in Group A(24.1%(7/29) vs.10.7%(3/28)),the seroconversion rate of HBsAg in Group B was slightly higher than that in Group A(20.7%(6/29) vs.7.1%(2/28);The negtive rate and seroconversion rate of HBsAg showed no significance between Group A and Group B(P>0.05);The seroconversion rate of HBeAg in Group B was significantly higher than that in Group A(62.1%(18/29) vs.35.7%(10/28),P<0.05);And there were no significant differences in the recovery rate of ALT and negative rate of HBV-DNA between Group A and Group B (P>0.05).Conclusion The combination therapy of pegIFNα-2a and ADV following HBV DNA load has been inhibited by ADV might improve the seroconversion rate of HBeAg in patients with chronic hepatitic B and contribute to the negative rate and seroconversion rate of HBsAg.
