基因工程干扰素α-2b联合拉米夫定治疗慢性乙型肝炎40例

Clinical Study on Treatment of Chronic Hepatitis B Using Combined IFN α-2b and Lamivudine

目的探讨基因工程干扰素α-2b(凯因益生)联合拉米夫定治疗慢性乙型肝炎的近期疗效及不良反应。方法将116例患者随机分成3组。A组40例给予凯因益生(第1～4周300万IU/d,以后改为300万IU,间日肌肉注射1次)及拉米夫定(100mg/d,口服)治疗6月,B组38例单用凯因益生治疗,C组38例单用拉米夫定治疗。结果3组患者血清谷丙转氨酶(ALT)均较治疗前显著下降,但A组降幅明显高于B,C两组(P<0.05);在HBeAg及HBV-DNA阴转率方面,A组的疗效明显优于B,C两组(P<0.05),未见明显不良反应。结论IFNα-2b联合拉米夫定具有改善肝功能和抑制乙肝病毒复制等功效,可作为慢性乙型肝炎的一种治疗方案,值得临床推广。

Objective To search the short- term efficacy and side effects of combined IFN α- 2b and lamivudine in the treatment of chronic hepatitis B. Methods 116 patients were randomly divided into three groups. The group A （40 patients） received 3 000 000 IU/d of IFN α -2b, im, for 1-4 weeks, then 3 000 000 IU/d, im, q. o. d and 100 mg/d of oral lamivudine was given for 6 months. The group B （38 patients） was given single IFNα- 2b. The group C （38 patients） received 100 mg/d of lamivudine. After completion of therapy, the changes of liver function and HBVM were observed. Results ALT was decreased in these three groups. But the group A was obviously higher than the group B and the group C（P〈0.05）.The negative rate of HBeAg was 57.5%, 42. 1% and 39.5%, respectively. The negative rate of HBV- DNA was 67.5%, 47.4% and 44.7%, respectively. The group A was higher than the group B and the group C（ P〈0.05）. Side effects were not found. Conclusion Recombinant IFN α-2b in combination with lamivudine can improve the liver function and inhibit HBV. It is worth spreading as a clinical method.