CAJ | 학술논문

目的：探讨低水平转氨酶慢性乙型肝炎的抗病毒疗效。方法：156例低水平转氨酶慢性乙型肝炎患者，随机分为e抗原阳性治疗组42例（A组）及对照组40例（B组），e抗原阴性治疗组36例（C组）及对照组38例（D组），治疗组给予派罗欣180μg皮下注射1次/周，24周后联合阿德福韦酯10 mg 1次/d，48周后停用派罗欣单用阿德福韦酯；对照组给予阿德福韦酯10 mg 1次/d。两组均按2005年版《慢性乙型肝炎防治指南》标准停药。结果：e抗原阳性治疗组与对照组在治疗48、72周时HBV-DNA阴转率、e抗原血清学转换率、停药24周复发率比较差异均有统计学意义（P<0.05）；e抗原阴性治疗组与对照组在治疗24、48、72周时HBV-DNA阴转率比较差异均无统计学意义（P>0.05），停药24周复发率比较差异有统计学意义（P<0.05）。结论：长效干扰素联合阿德福韦酯治疗低水平转氨酶慢性乙型肝炎对于e抗原阳性患者能够提高疗效及降低复发率，对于e抗原阴性患者能够降低复发率。
목적：탐토저수평전안매만성을형간염적항병독료효。방법：156례저수평전안매만성을형간염환자，수궤분위e항원양성치료조42례（A조）급대조조40례（B조），e항원음성치료조36례（C조）급대조조38례（D조），치료조급여파라흔180μg피하주사1차/주，24주후연합아덕복위지10 mg 1차/d，48주후정용파라흔단용아덕복위지；대조조급여아덕복위지10 mg 1차/d。량조균안2005년판《만성을형간염방치지남》표준정약。결과：e항원양성치료조여대조조재치료48、72주시HBV-DNA음전솔、e항원혈청학전환솔、정약24주복발솔비교차이균유통계학의의（P<0.05）；e항원음성치료조여대조조재치료24、48、72주시HBV-DNA음전솔비교차이균무통계학의의（P>0.05），정약24주복발솔비교차이유통계학의의（P<0.05）。결론：장효간우소연합아덕복위지치료저수평전안매만성을형간염대우e항원양성환자능구제고료효급강저복발솔，대우e항원음성환자능구강저복발솔。
Objective: To investigate the effect of antivirus treatment in chronic hepatitis B (CHB) patients with low ALT level.Method: 156 CHB patients with low ALT level were equally randomly divided into 4 groups: the HBeAg (+) treatment group (group A)for 42 cases and the control group (group B)for 40 cases; the HBeAg(-) treatment group (group C)for 36 cases and the corresponding control group (group D)for 38 cases. The patients in the HBeAg(+) or HBeAg(-) treatment group were respectively given peginterferon α-2a(180 μg) once a week,after 24 weeks, these patients were added with Adefovir dipivioxil(10 mg) once a day ,after 48 weeks,Peginterferon α-2a was stoped and Adefovir dipivioxil was given continually to the patients.Two control groups were respectively given Adefovir dipivioxil (10 mg, once a day), the stopping standand of antiviral drugs was according to the guideline of prevention and treatment for CHB in 2005,China.Result: The HBV-DNA conversion rates ,HBeAg conversion rates and the relapsing rate after stop of antivirus drugs for 24 weeks in group A were all significantly different from the group B(P<0.05); the HBV-DNA conversion rates after treatment for 24,48 and 72 weeks were not different between group C and group D(P>0.05), however, the relapsing rate after stop of antivirus drugs for 24 weeks in group C was significantly different from the group D (P<0.05).Conclusion:Peginterferon α-2a combined with Adefovir dipivioxil treatment may enhance therapeutic effect and lower relapsing rate in HBeAg(+) CHB patients with low ALT level, furthermore, it can decrease relapsing rate for HBeAg(-) CHB patients.