摘要
目的:观察比较拉米夫定联合IFNα-1b的序贯疗法与拉米夫定、IFNα-1b的单药疗法在治疗HBeAg阳性的慢性乙型肝炎方面的疗效差异。方法:将98例HBeAg阳性慢乙肝患者随机分为序贯治疗组、拉米夫定治疗组和IFNα-1b治疗组。序贯治疗组33例,年龄37.85±7.70岁,男/女:18/15,首先使用拉米夫定(100mg一日一次口服疗程24周),序贯使用IFNα-1b(60ug隔日一次皮下注射疗程28周),在第20周至24周同时使用拉米夫定和IFNα-1b,总疗程48周;拉米夫定治疗组34例,年龄39.42±6.88岁,男/女:20/14,仅口服拉米夫定,100mg一日一次口服,疗程48周;IFNα-1b治疗组31例,年龄35.71±6.14岁,男/女:14/17,仅皮下注射IFNα-lb,60ug隔日一次,疗程48周。治疗12周、24周、48周时检测肝功能、乙肝两对半、HBV-DNA等指标变化。结果:在治疗12周、24周时三组间肝功复常率、HBeAg阴转率无差异,序贯治疗组、拉米夫定组HBV-DNA阴转率优于IFNα-1b治疗组;实验疗程结束时序贯治疗组HBeAg阴转率、抗-HBe转换率及HBV-DNA阴转率显著高于其他两组,P<0.05,但在HBV-DNA阴转率方面序贯治疗组与拉米夫定治疗组差异不显著。结论:拉米夫定和IFNα-lb序贯疗法在HBV-DNA阴转率、HBeAg阴转率和抗HBe转换率三方面的疗效优于拉米夫定、IFNα-lb单一用药。
Objective: To compare the efficacy of sequential lamivudine and 1FNα-1b therapy versus lamivudine or IFNα-1b monotherapy in HBeAg positive chronic hepatitis B patients. Methods: 98 CHB with HBeAg positive patients were randomly divided into three groups: observation group was treated with combined lamivudine and IFNα-1b, (n=33,age:37.85 ± 7.70 years old, Male/Female: 18±15)received lamivudine (100 mg qd po)monotherapy from 1 st day to 24th weeks, then added IFNα-1b (6 MIU qod ih ) from 20th weeks to 48weeks; lamivudine group (n=34, age:39.42± 6.88 years old, Male/Female:20/14)was treated with lamivudine for 48 weeks; IFNα-1b group (n=31, age:35.71± 6.14 years old, Male/Female: 14/17 )was treated with IFNα-1b(6 MIU qod ih)for 48 weeks. Exam the liver function, HBsAg, HBsAb,HBeAg,HBeAb,HBcAb and HBV-DNA at 12th weeks,24th weeks and 48th weeks. Results: The rates of liver function normalization and HBeAg loss were not statistically significant among three groups at 12th and 24th weeks,but rate of HBV-DNA suppression (〈1000 copies / ml)in observation group and lamivudine group were higher significant than IFNα-1b group, P〈0.05; Rates of HBeAg loss and anti-HBe appearance in sequential therapy group were higher significant than other groups at end of experiment ,P〈0.05; but the rate of HBV-DNA suppression(〈1000 copies / ml) wasn't statistically significant between observation group and lamivudine group. Conclusions: The results demonstrate that sequential therapy is superior to lamivudine or IFNα-1b monotherapy in rates of HBV-DNA suppression, HBeAg loss and anti-HBe appearance.
出处
《现代生物医学进展》
CAS
2011年第19期3694-3696,3699,共4页
Progress in Modern Biomedicine