膦甲酸钠联合干扰素治疗慢性乙型病毒性肝炎的临床疗效

The clinical efficacy of combination therapy of foscarnet sodium and interferon in treatment of chronic hepatitis B

目的 :比较膦甲酸钠与干扰素联用和单用干扰素治疗慢性乙型肝炎的疗效。方法 :选择慢性乙型肝炎患者 6 1例 ,分为联合组 2 3例和干扰素组 38例 ;联合组用膦甲酸钠 4.8g静滴 ,qd ,疗程 1月 ,合并用干扰素α 1b30 0万u ,im ,隔日 1次 ,疗程 3个月。干扰素组单用干扰素。以谷丙转氨酶 (ALT)、乙肝病毒标志物 (HBVM )、乙肝病毒DNA及前C区基因野生株和变异株为观察指标 ,比较不同治疗方案对指标的影响。结果 :治疗 3个月后联合组与干扰素组对慢性乙肝患者血清HBeAg/抗 HBe转换率分别为 47.8%和 2 8.9% (P >0 .0 5 ) ;对慢性乙肝患者血清HBV DNA的阴转率分别为 6 9.5 %和 34.2 % (P <0 .0 1) ;对慢性乙肝患者HBV前C区基因野生株与变异株总阴转率分别为 6 9.6 %和 36 .8% (P <0 .0 5 )。联合组对慢性乙肝患者的ALT的复常率及HBsAg滴度的降低均强于干扰素组。结论 :膦甲酸钠与干扰素联用有协同作用 ,其抗病毒疗效均优于单用干扰素组。

Objective:To compare the efficacy of foscarnet sodium plus interferon therapy and interferon in treatment of chronic hepatitis B.Methods:61 patients with chronic hepatitis B were divided to receive combination therapy (foscarnet sodium infusion plus interferon im, n =23)or single interferon( n =38) im.The clinical efficacy was evaluated based on ALT,HBVM,DNA of hepatitis B virus,and wild-and mutant strain in front C gene peptide HBV.Results:The negative turnover rate of serum HBeAg/anti-HBe was 47.8% for combination group and 28.9% for single interferon group ( P > 0.05).The negative turnover rate of serum DNA of HBV was 69.5% for combination group and 34.2% for single interferon group( P <0.01).The negative turnover rate of wild and mutant strain in front C gene peptide HBV was 69.6% for combination group and 36.8% for single interferon group( P <0.05).The normalization in serum ALT and reduction in HBsAg titer in combination group was better than those of single interferon group.Conclusion:In treatment of patients with chronic hepatitis B,the antiviral effect of combination therapy is superior to that of interferon single therapy. [