乙型肝炎病毒基因型用干扰素α-2b联合苦参素治疗的临床研究

Clinical study of hepatitis B virus genotypes and therapeutic effect of interferon 2-2b combined with matrine in chronic hepatitis B

目的:研究乙型肝炎病毒基因型用干扰素α-2b联合苦参素治疗慢性乙型肝炎疗效的关系。方法:应用免疫荧光定量方法检测60例慢性乙型肝炎(慢乙肝)的乙肝病毒基因型,患者均在常规保肝治疗基础上应用干扰素α-2b和苦参素联合抗病毒治疗,疗程6个月。随访6个月。结果:治疗结束及随访6个月时血清HBeAg/HBeAb转换率、HBVDNA阴转率、HBVDNA降低2～5logL率为B基因型组分别为83.3%、83.3%、16.67%;66.67%、75.00%、25.00%;C基因型组分别为45.83%、47.92%、45.65%;35.42%、39.58%、41.67%。B基因型组与C基因型组比较,血清HBeAg/HBeAb转换率、HBVDNA阴转率、血清转氨酶及肝纤维化指标下降均有统计学意义(P<0.05)。结论:干扰素α-2b联合苦参素治疗慢性乙型肝炎疗效及随访观察疗效B基因型优于C基因型。

Objectlve：To study the hepatitis B virus genotypes and their relationship with the therapeutic effect of interferon 2-2b combined with matrine in chronic hepatitis B.Methods：The hepatitis B virus genotype in 60 cases of chronic hepatitis B was detected respectively by immunofluoreseence quantitative analysis.And based on the routine liver-protective treatment, all patients were given an associated antiveral therapy of interferon 2-2b and matrine for 6 months.The follow-up time was also 6 months.Results：At the end of treatment and follow-up,the transformation rates of serum HBeAg/HBeAb,the negative rates of serum HBV DNA and the depressed rates of serum HBV DNA in genotype B group were 83.3%,83.3%,16.67% ,66.67%,75.00%,25.00% respectively,and thos in genotype c group were 45.92%,45.65%,35.42%,35.58%,41.67% respectively.The serum ALT,AST and hepatic fibrosis of the patients in genotype B group showed significantly lower than those in genotype c group.There was significant difference in the therapeutic effect between two groups（P〈 0.05）.Conclusion：The clinical therapeutic effect of interferon 2-2b combined with matrine is very good for chronic hepatitis B,and the clinical therapeutic effect of genotype B is superior to that of genotype C.