CAJ | 학술논문

目的：比较拉米夫定干扰素序贯治疗与拉米夫定单药治疗HBeAg阳性慢性乙型肝炎患者的临床疗效。方法随机选取HbeAg阳性的慢性乙型肝炎患者198例，随机分为2组，观察组100例给予拉米夫定干扰素序贯治疗对照组98例给予单用拉米夫定治疗。2组分别于治疗6个月、实验结束时和随访结束时测定肝功能、乙肝抗原和HBV-DNA。结果治疗6个月时，观察组丙氨酸氨基转移酶(ALT)转为正常的例数、e抗原转为阴性的例数和HBV-DNA转为阴性的例数与对照组相比差异均无统计学意义。实验结束后观察组ALT转为正常的例数、e抗原转为阴性的例数和HBV-DNA转为阴性的例数均显著多于对照组，2组相比差异有统计学意义（P<0.05）。随访结束后，观察组ALT再次升高率、e抗原再次转为阳性率和HBV-DNA再次转为阳性率均显著低于对照组，2组相比差异有统计学意义（P<0.05）。结论拉米夫定单用治疗HBeAg阳性的慢性乙型肝炎在短疗程内有一定疗效，但长期应用疗效一般，且停药后容易出现反跳现象，而拉米夫定和干扰素序贯治疗长期疗效较好，且停药后反跳率较低，可以较好地弥补单用的不足，值得推广。
목적：비교랍미부정간우소서관치료여랍미부정단약치료HBeAg양성만성을형간염환자적림상료효。방법수궤선취HbeAg양성적만성을형간염환자198례，수궤분위2조，관찰조100례급여랍미부정간우소서관치료대조조98례급여단용랍미부정치료。2조분별우치료6개월、실험결속시화수방결속시측정간공능、을간항원화HBV-DNA。결과치료6개월시，관찰조병안산안기전이매(ALT)전위정상적례수、e항원전위음성적례수화HBV-DNA전위음성적례수여대조조상비차이균무통계학의의。실험결속후관찰조ALT전위정상적례수、e항원전위음성적례수화HBV-DNA전위음성적례수균현저다우대조조，2조상비차이유통계학의의（P<0.05）。수방결속후，관찰조ALT재차승고솔、e항원재차전위양성솔화HBV-DNA재차전위양성솔균현저저우대조조，2조상비차이유통계학의의（P<0.05）。결론랍미부정단용치료HBeAg양성적만성을형간염재단료정내유일정료효，단장기응용료효일반，차정약후용역출현반도현상，이랍미부정화간우소서관치료장기료효교호，차정약후반도솔교저，가이교호지미보단용적불족，치득추엄。
Objective To compare the therapeutic effect of lamivudine interferon sequential therapy and only lamivudine therapy in chronic hepatitis b patients.Methods Randomly selected HbeAg positive chronic hepatitis b 198 cases of patients, including 100 people in the observation group, sequential treatment for lamivudine interferonfi rst six months of lamivudine alone 100 mg/d. Then, starting from 7 months to 12 months, subcutaneously inject interferon5 million IU every two days. Control group of 98 people, to use lamivudine treatment, 100 mg/d over 12 months. Then follow up for 6 months. Test determination of liver,hepatitis b antigen and HBV-DNA in thefi rst 6 months, at the end of the experiment and at the end of the follow-up.Results The treatment of 6 months, the ALT into a normalnumber, e antigen into negative Numbers and HBV-DNA into negative number observation group and the control group are similar. The ALT into a normal number, e antigen into negative Numbers and HBV-DNA into negative number of the observation group are higher than the control group(P<0.05), after the follow-up,the rate of ALT rising again, e antigen again into the positive rate and the HBV-DNA again into positive rate lower than the control group(P<0.05).Conclusion The long-term curative effect of sequential therapyis better, and the bounce rate is low after the drug was stopped.