联合应用抗病毒和干扰素药物治疗e抗原阳性慢性乙型肝炎疗效观察

Study on the Curative Effect of Combined Use of Antiviral Drug Treatment and Interferon on Chronic Hepatitis B Patients Carrying Antigen E

【目的】探讨联合应用抗病毒和干扰素药物治疗e抗原（HBeAg）阳性慢性乙型肝炎患者的临床疗效。【方法】选择2013年10月至2015年3月本院收治的80例HBeAg阳性慢性乙型肝炎患者，将其随机分为观察组和对照组，每组各40例。所有患者从基线（第0天）起给予恩替卡韦（ETV）0．5mg，每天1次口服。所有患者服用至第12周末，第13周开始观察组在继续服用ETV的同时加用聚乙二醇干扰素-α-2a（PEG-IFN-α-2a）180μg，每周1次皮下注射，治疗12周；对照组继续给予ETV口服治疗12周。观察两组患者治疗24周后的疗效。【结果】研究组治疗的总有效率为92．5％，对照组总有效率为65．0％，研究组的有效率显著优于对照组，差异具有统计学意义（P〈0．05）；两组患者经药物治疗后血清HBV-DNA、HBeAg以及AlT水平均明显低于治疗前，差异具有统计学意义（P〈0．05）；治疗后观察组血清HBV-DNA、HBeAg、ALT水平均明显低于对照组，差异具有统计学意义（P〈0．05）。【结论】联合应用PEG-IFN-α-2a和ETV治疗HBeAg阳性慢性乙型肝炎与单独使用恩替卡韦治疗相比较有更好的临床效果，能够更好的抑制乙肝病毒的复制，改善患者肝功能。

[Objective] To study the effect of combined use of antiviral drug treatment and interferon on chronic hepatitis B patients carrying antigen E. [Methods] 80 cases of patients with chronic hepatitis 13 antigen E positive were chosen in October 2013 to March 2015 in our hospital. They were split randomly into two groups of 40 cases each： a control （EVT alone） and treated group （EVT plus IFN）. All patients from the baseline （day 0） were given ETV 0.5 rag, orally once a day. At the end of week 12, the patients in the treatment group continue to take ETV in addition to Peg IFN - Alpha - 2a, 180 ug, were subcutaneously injected once a week. Meanwhile, the control group continued to use ETV oral treatment. Outcome were observed at 24 weeks. [Results] The overall effective rate of the treatment group was 92.5%; the overall effective rate of the control group was 65.0%. Compared to the control group, the treatment group efficacy was significantly better （ P 〈0.05）.Compared to before treatment, both groups of patients after drug treatment for HBV- DNA, HBeAg and serum ALT levels were reduced significantly （ P 〈0.05）. The decreased serum levels of ALT and HBeAg in the treatment group were significantly lower compared to the levels of the control group and the difference was statistically significant （ P 〈0.05）. [Conclusion] Combined use of ETV and Polyethy- lene Glycol Interferon Alpha 2a on HBeAg positive chronic hepatitis 13 patients have better clinical effect than the use of ETV therapy alone because it plays a significant role in reducing HBV DNA replication and improving liver function.