重组人干扰素α-1b联合拉米夫定治疗HBeAg阳性慢性乙型肝炎疗效分析

Curative effect of recombinant human interferon α-1b combined with lamivudine on treatment HBeAg positive chronic hepatitis B

目的分析重组人干扰素α-1b和加用拉米夫定治疗HBeAg阳性慢性乙型肝炎患者的疗效和安全性,分析不同因素对疗效的影响,探索慢性乙型肝炎患者联合抗病毒治疗方法的优点。方法选择HBeAg阳性慢性乙型肝炎患者111例,随机分为治疗组和对照组。治疗组62例给予重组人干扰素α-1b(50μg/次,隔日1次,肌肉注射)加拉米夫定(100mg/d,口服),疗程为6～12个月或12个月以上。对照组49例给予重组人干扰素α-1b单药治疗(方法同前)。结果①治疗组12和18个月HBeAg血清学转换率分别为29.03%和38.71%;对照组12和18个月HBeAg血清学转换率分别为28.57%和36.73%,两组比较差异无统计学意义。②治疗组6、12、18个月的HBVDNA低于检测下限率分别为66.13%、83.87%和88.71%,对照组为8.16%、53.06%和57.14%;两组比较差异具有统计学意义。③性别、年龄对HBeAg血清学转换率无影响,治疗前HBVDNA<6log10拷贝/ml者HBeAg血清转换率较高。④重组人干扰素α-1b组发热及血象异常发生率分别为32.26%和27.42%,对照组分别为36.73%和34.69%,两组差异无统计学意义。结论重组人干扰素α-1b联合拉米夫定治疗HBeAg血清学转换率与单用重组人干扰素α-1b无明显差异,但HBVDNA低于检测下限率明显高于单用重组人干扰素α-1b组。拉米夫定的耐药率明显降低。

Objective To explore the treatment effect and safety of recombinant human interferon α-1b combined with lamivudine on treatment HBeAg positive chronic hepatitis B patients,to analyze the impact of different factors on the effect,and to explore the advantages of the joint anti-viral treatment of patients with chronic hepatitis B.Methods 111 patients with HBeAg-positive chronic hepatitis B were included in the study.62 cases of treatment group were treated with recombinant human interferon alpha-1b（50μg/times,every other day,intramuscularly） and plus lamivudine（100mg/day,orally）,treatment for 6～12 months or more than 12 months.49 cases of the control group were treated with recombinant human interferon α-1b monotherapy（the same way as before）.Results ①In the treatment group,12 months and 18 months HBeAg seroconversion rates were 29.03% and 38.71%,the control group,12 months and 18 months of HBeAg seroconversion rates were 28.57% and 36.73%,respectively,the difference was not statistically significant.② In the treatment group,6 months,12 months,18 months,HBV DNA below the lower limit of detection rates were 66.13%,83.87% and 88.71%,respectively,the control group were 8.16%,53.06% and 57.14%,respectively,between the two groups the difference was statistically significant.③ Gender,age had no effect on the rate of HBeAg seroconversion,pre-treatment HBV DNA 〈60 log10 copies/ml had higher HBeAg seroconversion rate.④In the group of recombinant human interferon α-1b,fever and abnormal blood incidence were 32.26% and 27.42%,respectively,the control group were 36.73% and 34.69%,the difference was not statistically significant.Conclusion Recombinant human interferon α-1b in combination with lamivudine in the treatment of HBeAg seroconversion rate wasn’t significant difference,but HBV DNA below the detection the lower limit was significantly higher than with recombinant human interferon α-1bgroup.Lamivudineresistancerateswassignificantlylower.