CAJ | 학술논문

目的：探究拉米夫定和重组人干扰素α-2b联合治疗慢性乙型病毒性肝炎的临床疗效和安全性。方法选择2012年5月~2013年6月于我院接受治疗的86例已确诊为慢性乙型病毒性肝炎的患者作为研究对象，所有患者均给予常规的护肝治疗并随机分为实验组和对照组。其中对照组患者40例，在常规治疗的基础上给予拉米夫定进行治疗；实验组患者46例，实验组患者在此基础上联合应用重组人干扰素α-2b进行治疗，两组患者的治疗疗程均为48周，观察两组患者治疗后血常规、血清HBV复制指标和肝功能的变化及不良反应情况。结果治疗24周后，两组患者临床指标丙氨酸氨基转移酶（ALT）复常率、乙肝病毒脱氧核糖核酸（HBV-DNA）阴转率、乙型肝炎病毒e抗原（HBeAg）阴转率、HBeAg转化率比较，差异无统计学意义（P>0.05）；治疗48周后，以上临床指标比较，差异有统计学意义（P<0.05），实验组的总有效率显著高于对照组（P<0.05）。两组患者不良反应发生率比较，差异无统计学意义（P>0.05）。结论拉米夫定和重组人干扰素α-2b联合治疗慢性乙型病毒性肝炎疗效显著，且优于单纯应用拉米夫定治疗，无明显不良反应，安全性可靠，值得临床推广应用。
목적：탐구랍미부정화중조인간우소α-2b연합치료만성을형병독성간염적림상료효화안전성。방법선택2012년5월~2013년6월우아원접수치료적86례이학진위만성을형병독성간염적환자작위연구대상，소유환자균급여상규적호간치료병수궤분위실험조화대조조。기중대조조환자40례，재상규치료적기출상급여랍미부정진행치료；실험조환자46례，실험조환자재차기출상연합응용중조인간우소α-2b진행치료，량조환자적치료료정균위48주，관찰량조환자치료후혈상규、혈청HBV복제지표화간공능적변화급불량반응정황。결과치료24주후，량조환자림상지표병안산안기전이매（ALT）복상솔、을간병독탈양핵당핵산（HBV-DNA）음전솔、을형간염병독e항원（HBeAg）음전솔、HBeAg전화솔비교，차이무통계학의의（P>0.05）；치료48주후，이상림상지표비교，차이유통계학의의（P<0.05），실험조적총유효솔현저고우대조조（P<0.05）。량조환자불량반응발생솔비교，차이무통계학의의（P>0.05）。결론랍미부정화중조인간우소α-2b연합치료만성을형병독성간염료효현저，차우우단순응용랍미부정치료，무명현불량반응，안전성가고，치득림상추엄응용。
Objective To explore the clinical effect and safety of lamivudine combined with recombinant human inter-feron α-2b in the treatment of chronic viral hepatitis B. Methods Eighty-six patients diagnosed as chronic viral hep-atitis B from May 2012 to June 2013 in our hospital were selected as research objects.All patients were treated with conventional hepatic protection and randomly divided into experimental group and control group.In the control group(n=40),on the basis of the conventional treatment,lamivudine was provided,while in the experimental group (n=46),on the basis of the control group,recombinant human interferonα-2b was added.The courses of treatment lasted 48 weeks.The blood routine examinations,serum HBV replication,changes of liver function,and adverse reactions between groups was observed respectively. Results After 24 hours treatment,the normalizing rate of glutamic transaminase,negative conver-sion rates of HBV-DNA and HBeAg,and percent conversion of HBeAg didn’t display statistical differences between two groups(P>0.05).After 48 weeks treatment,these clinical indexes mentioned above indicated statistical differences,the to-tal effective rate in experimental group was much higher than that in control group (P<0.05).Incidence of adverse reac-tions didn’t show a significant difference (P>0.05). Conclusion Combination of lamivudine and recombinant human in-terferon α-2b obtains a remarkable effect on treating chronic viral hepatitis B.The effect is better than that only by lamivudine.It has no obvious adverse reaction and is with a reliable security,which is worthy of clinical promotion.