拉米夫定和重组α-2b干扰素序贯治疗慢性乙型肝炎的疗效观察

Observation on the effect of lamivudine plus recombinant α-2b interferon in sequential therapy for chronic hepatitis B

目的探讨拉米夫定和干扰素序贯治疗慢性乙型肝炎的疗效。方法将92例患者分为两组,每组46例,治疗组先用拉米夫定100mg/d,应用5个月后联用重组α-2b干扰素5Mu/次,肌内注射,隔日1次,第6个月后停用拉米夫定,继续单独使用干扰素5个月;对照组单用拉米夫定100mg/d,疗程18个月。结果在疗程结束时治疗组的ALT复常率、HBV-DNA阴转率HBeAg/抗-HBe血清转换率分别为93·5%、89·1%、54·3%,对照组则为82·6%、71·7%、19·6%。疗程结束后6个月治疗组与对照组HBV-DNA阴转持续应答率分别为84·8%、32·6%。结论拉米夫定与重组α-2b干扰素序贯治疗慢性乙型肝炎有较好的短期疗效,具有深入研究价值。

Objective To explore the efficacy of lamivudine and interferon in sequential therapy for chronic hepatitis B. Methods 92 cases of chronic hepatitis B patients were randomly divided into treatment group（n = 46） and control group（ n = 46）. In the treatment group, the patients were treated with lamivudine 100mg/d for 5 months,then combined with recombinant α-2b interferon（IFN） 5Mu/dose, muscle injection, once per two days. Then the lamivudine was discontinued at sixth month and the patients were continuously treated with only interferon for 5 months. In the control group,the patients were treated with only lamivudine 100mg/d for 18 months. Results At the end of treatment, the normalization rate of ALT, HBV-DNA negative conversion rate and HBeAg/anti-HBe seroconversion rate were 93.5 % ,89.1% and 54.3 % in the treatment group, then they were 82.6 %, 71.7 % and 19.6 % in the control group. Six months later,the sustained response rate of HBV-DNA conversion between treatment group and control group were 84.8 % and 32.6 %. Conclusion Lamivudine and interferon has better shortterm efficacy in sequential therapy for chronic hepatitis B and it is worth further studying.