丽珠风(Famciclovir)单用及联合干扰素α-1b治疗慢性乙型肝炎临床疗效观察

Comparative Trial of Curative Effect between Famciclovir and Famciclovir Combined with Iterferon-1b Treatments

目的 本研究评估单独使用丽珠风 (泛昔洛韦 )及干扰素 (IFN ,赛诺金 ) ,对慢性乙型肝炎 (CHB)的抗病毒和临床疗效及其安全性。方法 34例HBeAg阳性的慢性乙型肝炎分为A、B两组 ,分别用泛昔洛韦与赛诺金联合治疗及单用泛昔洛韦。A组 :用泛昔洛韦 50 0mg ,3次 /d口服 ,IFN - 1b3Mμ× 14,1次 /d肌注 ,以后隔日 1次肌注均为 16周 1疗程 ;B组 :泛昔洛韦 50 0mg 3次 /d口服 ,均为 16周。两组病例治疗前、中、后均作生化指标及病毒学指标检测。结果 治疗结束时 ,ALT水平在A、B两组分别下降至 70 2± 5 76 (u/L)和 82 4±7 84 (u/L) ,较治疗前 2 86 5± 12 7 4 (u/L)和 2 70 5± 136 6 (u/L)明显下降 (P <0 0 1)。HBVDNA阴转率分别为 58 82 % (10 /17)和 4 1 12 % (7/17) ;两组HBeAg阴转率分别为 52 94 % (9/17)和 4 7 0 6 % (8/17)。结论 采用泛昔洛韦与赛诺金联合或单独用泛昔洛韦均无严重副作用 ,两种疗法均取得较好的疗效 ,联合疗法似乎优于单独治疗 ,但统计学无显著差异 (P >0 0 5)。目前 ,我们正在扩大病例观察 ,其远期、持久的疗效正在随访中 ,尚待进一步观察。

Objective To assess the curative efficiency of anti-virus safety of single use of famciclovir and famciclovir combined with interferon-1b in treatment of chronic hepatitis B. Methods 34 patients with chronic hepatitis B and HbeAg-positive were randomly divided into group A and group B. The patients in group A took the pills of famciclovir 500mg/time t.i.d. for 16 weeks. The muscular injection of IFN-1b 3mu/day for 2 weeks and then every other day for 14 weeks. The patients in group B only took the pills of famciclovir 500mg/time t.i.d. for 16 weeks. the biochemical and virus data of all the patients were detected before, at and after treatment. Results The level of ALT in the patients of Group A and B decreased to 70.2±5.76 and 82.4±7.84 respectively at the end of treatment. It decreased obviously comparing with the level of ALT of pre-treatment 286.5±127.4 and 270.5±136.6 (P<0.01) The negative-transforming rate of HBV were 58.82% (10/17) and 41.12% (7/17) respectively. Conclusion The better curative effects could be reached in both treatment methods and without sever side effects. The combined treatment seems to be better than single use of famciclovir but there was no statistical difference between two groups. The large specimen of cases and long-term curative effect should be observed further with follow-up.