比较α-干扰素不同联合治疗方案对儿童HBeAg阳性慢性乙型肝炎的疗效

Comparison of different combination therapies for children with HBeAg positive chronic hepatitis B

目的 评估两种不同的α-干扰素联合治疗对儿童HBeAg阳性慢性乙型肝炎的临床疗效。方法 选择HBeAg阳性慢性乙型肝炎儿童120例，随机分为3组，每组各40例：第1组（A组）为α-干扰素（IFN-α）组；第2组（B组）为IFN-α＋拉米夫定（LAM）组。第3组（C组）为α-干扰素（IFN-α）＋乙肝疫苗组。其中干扰素疗程6个月，拉米夫定疗程6个月，所有病例均观察至12个月。结果 治疗结束时丙氨酸转氨酶（ALT）复常率3组无差异。治疗6个月和12个月时B组HBeAg阴转率和HBV DNA的阴转率明显高于A组和B组，差异有统计学意义（P〈0．05）。结论 α-干扰素与拉米夫定联合治疗对HBeAg阳性慢性乙型肝炎儿童的病毒学应答（VR）疗效明显优于单用α-干扰素组和α-干扰素＋乙肝疫苗组。

Objective To evaluate the advantages of combination therapy with interferon-alpha plus nueleoside analogne-lamivudine or HBV vaccine in children with HBeAg positive chronic hepatitis B. Methods A total of 120 patients with HBeAg positive chronic hepatitis B were divided into three groups,40 patients per group. Each group was treated with one of the following therapies respectively： Group A- IFN-alpha 1b 10 MU/m^2 ,three times per week （Tiw） ; Group B IFN-alpha 1b 10MU/m^2 ,three times per week （Tiw） plus lamivudine 3 mg/kg for 6 months. Group C： IFN-alpha 1b 10 MU/m^2 ,three times per week （Tiw）,plus HBV vaccine 30 μg,one a month. Results There was no significant difference in normalizing rate of ALT among the three groups at end of treatment. There was more significant difference in negative rate （seroconversion） of serum HBV DNA and HBeAg in group B than group A and group C （ P 〈 0.05 ）. Conclusion The combination therapy of IFN-alpha 1b plus lamivudine seemed to be more effective than the therapy with IFN-alpha alone and the combination of IFN-alpha and HBV vaccine.