α2a-长效干扰素治疗拉米夫定失败的慢性乙型肝炎患者临床分析

Investigation of PEG-IFNα2a treatment of chronic hepatitis B patients who failed to lamivudine therapy

目的评价α2a-长效干扰素(派罗欣)治疗拉米夫定治疗失败的慢性乙型肝炎患者的疗效和安全性。方法选择40例经拉米夫定治疗失败的慢性乙型肝炎患者,随机分为两组:观察组20例,给予派罗欣180μg,皮下注射,每周一次;对照组20例,给予阿德福韦酯片10mg,每日一次口服。疗程48周。结果观察组在12周、24周、48周HBVDNA水平分别从治疗前的8.97log10下降至7.21log10、5.18log10、3.17log10;HBsAg阴转率为5%(1/20);HBeAg血清转换率分别为15%、30%、45%;以上结果与对照组有显著性差异。治疗期间,患者不良事件发生率为25%,无严重不良事件。结论派罗欣治疗拉米夫定治疗失败的慢性乙型肝炎患者,可明显降低HBVDNA水平,促进HBsAg和HBeAg阴转,使用安全,耐受性好。

Objective To evaluate the efficacy and safety of PEG-IFNα2a in treating chronic hepatitis B patients who failed to lamivudine therapy. Methods 40 CHB patients were enrolled and randomized into therapeutic group （n= 20） and control group （n= 20）. The therapeutic group was assigned to receive PEG-IFNα2a at 180μg weekly for 48 weeks, and patients in control group were treated with adefovir dipivoxil at 10mg once daily for 48 weeks. Results The serum HBV DNA decreased from 8.97 logl0 to 7.21 log10 at week 12, to 5.18 log10 at week 24 and to 3. 17 logl0 at week 24. The HBsAg seroconversion was 5% at the end of the study and the HBeAg seroconversion was 15% at week 12. 30% at week 24 and 45% at week 24. There was no patient who had a severe adverse event during the trial. Conclusion PEG-IFNα2a can effectively inhibit the replication of HBV DNA and normalize the levels of ALT in CHB patients who failed to lamivudine therapy.