干扰素联合核苷(酸)类似物治疗慢性乙型肝炎的疗效观察

何艳; 唐晓鹏; 郑宣鹤; 姚运海; 张权; 张永红; 陈军

干扰素联合核苷(酸)类似物治疗慢性乙型肝炎的疗效观察

中南大学湘雅二医院感染科

详细信息

中图分类号: R512.62
计量
- 文章访问数: 204
- HTML全文浏览量: 18
- PDF下载量: 276
- 被引次数: 0
出版历程
- 出版日期: 2013-02-20

Therapeutic efficacy of combination therapy with interferon and a nucleoside analogue for treating chronic hepatitis B patients

摘要

摘要:
目的观察干扰素（IFN）与核苷（酸）类似物联合治疗慢性乙型肝炎的疗效。方法选择慢性乙型肝炎病例207例,分别予聚乙二醇干扰素（PEG-IFNα-2a或IFNα-2b）治疗52周,随访24周,其中146例（A组）初始24周联合核苷（酸）类似物治疗（59例联合拉米夫定,56例联合阿德福韦酯,31例联合恩替卡韦）,另61例单用IFN治疗（B组）。结果 A、B组治疗结束时HBV DNA阴转率分别为86.3%（126/146）、65.6%（40/61）;ALT复常率87.7%（128/146）、76.5%（39/61）;HBeAg阴转率分别为69.3%（70/101）、40%（10/25）;HBsAg阴转率分别为30.1%（44/146）、16.4%（10/61）;抗-HBs阳转率分别为26.7%（39/146）、11.5%（7/61）,差异均有统计学意义（P<0.05）。结论 IFN联合核苷（酸）类似物治疗慢性乙型肝炎的疗效优于单用IFN组。
- 肝炎,乙型,慢性 /
- 干扰素类 /
- 核酸类,核苷酸类和核苷类
Abstract:
Objective To observe the therapeutic efficacy of combination therapy with interferon (IFN) and a nucleoside analogue for treating chronic hepatitis B (CHB) patients.Methods Two-hundred-and-seven patients diagnosed with CHB were assigned to the following treatment groups:IFN in combination with a nucleoside analogue (group A) ;IFN monotherapy (group B) .The patients in group A were further divided into three combination treatment sub-groups, according to the particular nucleoside analogue administered:lamivudine (LAM;sub-group A1, n=59) ;adefovir dipivoxil (ADV;sub-group A2, n=56) ;and entecavir (ETV;sub-group A3;n=31) .All of the patients received pegylated-IFN (either IFN-2a or IFN-2b) for 52 weeks.The patients in group A received the combination therapy with nucleoside analogue immediately upon initiation of the IFN treatment and lasting for a total of 24 weeks, after which IFN monotherapy was carried out.Results In groups A and B, respectively, 86.3% and 65.6% achieved undetectable levels of HBV DNA at the end of treatment.However, group A achieved a higher rate of alanine aminotransferase (ALT) normalization rate (87.7% vs.group B:76.5%, P<0.05) .Group A also achieved a significantly higher rates of hepatitis B e antigen (HBeAg) clearance (69.3% vs.group B:40%, P<0.05) , hepatitis B surface antigen (HBsAg) clearance (30.1% vs.group B:16.4%, P<0.05) , and HBsAg seroconversion (26.7% vs.group B:11.5%, P<0.05) .Conclusion The combination treatment of IFN plus a nucleoside analogue is more efficacious than IFN monotherapy for treating CHB patients.
- hepatitis B /
- chronic /
- interferons nucleic acids

HTML全文

参考文献(9)

[1]Perrillo RP, Schiff ER, Davis GL, et al.A randomized, con-trolled trial of interferon alfa-2b alone and after prednisonewithdrawal for the treatment of chronic hepatitis B[J].N En-gl J Med, 1990, 323 (5) :295-301.

[2]Flink HJ, van Zonneveld M, Hansen BE, et al.Treatmentwith Peg-interferon alfa-2b for HBeAg-positive chronichepatitis B:HBeAg loss is associated with HBV genotype[J].Am J Gastroenterol, 2006, 101 (2) :297-303.

[3]娄海山.拉米夫定联合干扰素α-2b治疗慢性乙型肝炎疗效观察[J].生物医学工程与临床, 2012, 16 (2) :179-180.

[4]Wu FL, Ding Y, Dou XG.Peginterferonα-2a and ade fovirdipivoxil combination therapy for chronic hepatitis B:a Meta-analysis[J].Pract Pharm Clin Remed, 2012, 15 (1) :4-10. (in Chinese) 吴发玲, 丁洋, 窦晓光.聚乙二醇干扰素α-2a联合阿德福韦酯治疗慢性乙型肝炎的Meta分析[J].实用药物与临床, 2012, 15 (1) :4-10.

[5]Bart T, Valeska T, Hans Z, et al.Intrahepatic response markersin chronic hepatitis B patients treated with peginterferon alpha-2a and adefovir[J].J Gastroenterol Hepatol, 2011, 26 (10) :1527-1535.

[6]Piccolo P, Lenci I, Demelia L, et al.A randomized controlledtrial of pegylated interferon-alpha2a plus adefovir dipivoxilfor hepatitis B e antigen-negative chronic hepatitis B[J].Antivir Ther, 2009, 14 (8) :1165-1174.

[7]Wang YD, Zhao CY, Shen C, et al.A comparative study onthe treatment efficiency of pegylated interferonα-2a incombination with adefovir dipivoxil in HBeAg positive chronichepatitis B patients[J].Chin J Viral Dis, 2011, 1 (1) :58-63. (in Chinese) 王亚东, 赵彩彦, 申川, 等.聚乙二醇干扰素α-2a联合阿德福韦酯治疗HBeAg阳性慢性乙型肝炎优化策略初探[J].中国病毒病杂志, 2011, 1 (1) :58-63.

[8]McMahon BJ.The natural history of chronic hepatitis B virusinfection[J].Hepatology, 2009, 49 (Suppl 5) :s45-s55.

[9]Wursthorn K, Lutgehetmann M, Dandri M, et al.Peginter-feron alph-2b plus adefovir induce strong cccDNA declineand HBsAg reduction in patients with chronic hepatitis B[J].Hepatology, 2006, 44 (3) :675-684.

施引文献

资源附件(0)

访问统计