α-干扰素与拉米夫定联合治疗慢性乙型肝炎的疗效观察

Clinical evaluation of lamivudine and its combination of interferon α therapy on chronic hepatitis B.

目的对比观察单用拉米夫定与其联合α干扰素治疗慢性乙型肝炎的疗效和安全性。方法拉米夫定组56例,给予拉米夫定100mg/日,服用12～15个月;联合组54例,给予拉米夫定100mg/日,两周后联合α干扰素3～5MU肌肉注射,每周3次,连用6个月,继续服用拉米夫定100mg/日,至12～15个月。并继续随访6个月,观察治疗6个月、12个月治疗结果。结果拉米夫定组和联合组6个月时HBVDNA阴转率分别为96.7%和97.8%;ALT/AST复常率分别为88.5%/90.5%和88%/93.1%(P>0.05);HBeAg的血清学转换率分别为22%和29.3%(P>0.05)。12个月时两组ALT/AST复常率为91%/91.6%和89%/92.5%(P>0.05);HBeAg血清学转换率为40%和56%,P<0.05。结论拉米夫定联合干扰素治疗慢性乙型肝炎,安全性、耐受性良好。联合组治疗1年后HBeAg血清转换率明显高于单用拉米夫定组。

Objective To observe the safety and efficacy of lamivudine alone or its combination with interferon alpha as antiviral therapy for patients with chronic hepatitis B.Methods Fifty six patients were enrolled to receive lamivudine alone once daily for 12～15 months and other fifty four patients to receive lamivudine for 12～15 months and interferon alpha for six months.All cases were evaluated periodically during the treatment and followed up for 6 months.Results At the end of therapy,HbeAg seroconversion rates,normalization of ALT in the two groups were 40% and 56% ( P <0.05) and 91% and 91.6%,respectively.Conclusion The effectiveness and tolerability of combined interferon alpha and lamivudine is a promising antiviral strategy in the treatment of chronic hepatitis B.