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干扰素治疗B、C基因型慢性乙型肝炎临床效果差异的Meta分析
Clinical effect of interferon in treatment of genotype B or C chronic hepatitis B patients: A meta-analysis
文章发布日期:2019年05月13日  来源:  作者:李敏,单姗,吴晓宁,等  点击次数:383次  下载次数:157次

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【摘要】:目的综合评价干扰素治疗B、C基因型慢性乙型肝炎(CHB)患者的疗效差异。方法计算机检索PubMed、Web of Science、The Cochrane Library、CNKI、万方和VIP数据库截止到2018年11月发表的关于干扰素治疗B、C基因型CHB患者疗效差异的文献。2位研究者独立筛选文献、提取资料并评价所纳入文献的质量,然后进行Meta分析。结果共纳入20篇研究文献,Meta分析结果显示,干扰素治疗B基因型CHB患者的HBV DNA阴转率、HBeAg清除率、HBeAg血清学转换率、HBsAg清除率,以及ALT复常率均明显高于C基因型CHB患者(比值比分别为2.95、3.16、1.83、2.59、2.31,95%可信区间分别为2.22~3.91、2.38~4.20、1.44~2.33、1.05~6.38、1.69~3.16,P值均<005)。亚组分析结果显示,干扰素在B、C基因型CHB患者中的疗效差异不受干扰素种类的影响。结论干扰素的抗病毒效果受到HBV基因型的影响,B基因型抗病毒效果优于C基因型,因此,HBV基因型是预测干扰素疗效的重要因素。
【Abstract】:ObjectiveTo investigate the clinical effect of interferon (IFN) in the treatment of genotype B or C chronic hepatitis B (CHB) patients. MethodsPubMed, Web of Science, The Cochrane Library, CNKI, Wanfang Data, and VIP were searched for articles on IFN in the treatment of genotype B or C CHB patients published up to November, 2018. Two researchers performed screening, data extraction, and quality assessment of the articles independently, and then a meta-analysis was performed. ResultsA total of 20 articles were included. The results of the meta-analysis showed that compared with the genotype C CHB patients, the genotype B CHB patients had significantly higher HBV DNA clearance rate (odds ratio [OR]=2.95, 95% confidence interval [CI]: 2.22-3.91,P<005), HBeAg clearance rate (OR=3.16, 95%CI: 2.38-4.20,P<005), HBeAg seroconversion rate (OR=1.83, 95%CI: 1.44-2.33,P<005), HBsAg clearance rate (OR=2.59, 95%CI: 1.05-6.38,P<005), and alanine aminotransferase normalization rate (OR=2.31, 95%CI: 1.69-316,P<005). The subgroup analysis showed that the clinical effect of IFN in genotype B or C CHB patients was not affected by the type of IFN. ConclusionThe antiviral effect of IFNs is affected by HBV genotype, and the patients with genotype B CHB have a better antiviral outcome than those with genotype C CHB. Therefore, HBV genotype is an important factor for predicting the clinical effect of IFN therapy.
【关键字】:肝炎, 乙型, 慢性; 基因型; 干扰素类; 治疗结果; Meta分析
【Key words】:hepatitis B, chronic; genotype; interferons; treatment outcome; Meta-analysis
【引证本文】:LI M, SHAN S, WU XN, et al. Clinical effect of interferon in treatment of genotype B or C chronic hepatitis B patients: A meta-analysis[J]. J Clin Hepatol, 2019, 35(6): 1256-1261. (in Chinese)
李敏, 单姗, 吴晓宁, 等. 干扰素治疗B、C基因型慢性乙型肝炎临床效果差异的Meta分析[J]. 临床肝胆病杂志, 2019, 35(6): 1256-1261.

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