干扰素-α与拉米夫定配伍治疗对慢性乙型肝炎预后的影响

Effects of interferon-α and lamivudine therapy on the prognosis of patients with chronic hepatitis B virus infection

目的:研究干扰素-α和拉米夫定治疗对慢性乙型肝炎(CHB)预后的影响。方法:回顾性研究456例慢性乙型肝炎病毒感染相关肝病住院患者,分析干扰素-α和拉米夫定治疗对CHB进展至终末期肝病(ESLD)包括肝硬化、重型肝炎、原发性肝癌的影响。结果:分别有68例、55例和365例患者曾接受干扰素-α、拉米夫定和未接受抗病毒治疗,其中32例患者曾接受干扰素-α和拉米夫定治疗。365例未抗病毒治疗者中116例进展为ESLD,68例干扰素-α治疗者中10例进展为ESLD,差异有统计学意义,其中30例治疗结束时获得病毒学和生化学联合应答者仅2例进展至ESLD;55例拉米夫定治疗者(平均疗程15.8月)中有13例进展为ESLD,与未接受抗病毒治疗者相比,差异无统计学意义;32例曾接受拉米夫定和干扰素-α治疗,7例进展为ESLD,与未接受抗病毒治疗者相比,差异无统计学意义。结论:干扰素-α治疗能减少慢性乙型肝炎进展至ESLD,尤其是治疗结束时获得病毒学和生化学联合应答者;短疗程拉米夫定治疗未能明显影响其预后。

Objective： To investigate the effects of interferon（IFN）-α and lamivudine therapy on the prognosis of patients with chronic hepatitis B virus （HBV） infection. Methods： 456 patients with chronic HBV infection-related liver disease were retrospectively investigated. Results： There were 68, 55 and 365 patients had received IFN-α, lamivudine and without antiviral therapy respectively. Thirty two patients had received IFN-α and lamivudine treatment simultaneously or successively. End stage liver diseases （ESLD） were found in 116 out of 365 patients without antiviral therapy and 10 out of 68 patients received IFN-α treatment, and 13 out of 55 patients received lamivudine（15.8 months） treatment. Only 2 out of 30 patients who received IFN-α treatment and obtained virological and biochemical response at the end of treatment progressed to ESLD. Conelutions： IFN-α treatment delays clinical progression in patients with chronic hepatitis B by significantly reducing the incidence of end stage liver diseases. Short course of lamivudine treatment failed to significantly improve the prognosis of patients with chronic hepatitis B.