聚乙二醇化干扰素α-2a治疗慢性乙型肝炎疗效观察

Observation on short-term effect of Peginterferonα-2a treating chronic hepatitis B

目的观察聚乙二醇化干扰素-α2a(PEG-IFN-α2a)治疗慢性乙型肝炎近期疗效。方法66例慢性乙型肝炎接受PEG-IFNα-2a治疗,观察治疗前、治疗第12、24、36、48w的肝功能、HBVDNA和HBV血清标志物变化。结果治疗后12、48w的HBeAg阴转率分别为32.5%(13/40)和60.0%(24/40),差异有统计学意义(P<0.05)。治疗12、24、36、48w时,HBeAg血清学转换率分别为20%(8/40)、35.0%(14/40)、42.5%(17/40)、55.0%(22/40),差异有统计学意义(P<0.05);HBeAg阳性与阴性的HBVDNA阴转率或ALT复常率的差异无统计学意义(P>0.05)。G3期治疗48wHBVDNA阴转率、HBeAg血清学转换率高于G1期,差异有统计学意义(P<0.05)。不同ALT基线水平治疗48w后HBVDNA阴转率存在差异(P<0.05)。结论HBeAg阳性者不宜仅根据治疗12w时血清学应答进行疗效预测。G3期治疗应答率高于G1期,ALT基线水平高的应答率高(P<0.05)。

Objective To observe the short term effect of pegiterferon α-2a （PEGIFNα-2a） in treating chronic hepatitis B. Methods Sixty-six chronic hepatitis B cases were treated by PEGIFNα-2a. The liver function, HBVDNA and HBV markers were observed before treatment,and in 12th week, 24th week, 36th week and 48th week. Results The ratio of HBeAg turned negative was 32.5% （13/40）in 12th week and 60.0 %（24/40） in 48th week. The difference was significant（P〈 0.05）. In 12th, 24th, 36th and 48th week,the HBeAg/antiHBe seroconversion ratios were 20% （8/ 40）, 35.0%（14/40）, 42.5%（17/40） and 55.0%（22/40）. The ratios have significant difference from each other （P〈0.05）. While the percentage of cases with negative HBVDNA test and normal of ALT level in those times haven＇t shown any significantly difference between HBeAg group and negative group （P〉0.05）. The percentages of HBVDNA turned negative and the ratio of HBeAg/antiHBe seroconversion in 48th week of stage G3 were significantly higher than that of stage G1（P〉0.05）. Different baseline ALT level have different percentage of HBVDNA turned negative in 48th week （P〈 0.05）. Conclusion HBeAg positive CHB＇s serum response in 12th week is not suitable for effect forecast. Stage G3 has a higher response ratio than that of stage G1. High baseline ALT level has a higher response ratio（P〈0.05）.