干扰素加核苷类似物治疗对乙肝患者肝细胞内HBVcccDNA和tDNA及血清HBsAg的影响分析

Influence of hepatitis B patients within liver cells HBVcccDNA,tDNA and serum HBsAg interferon plus nucleoside analogues to treat analysis

[目的]探讨慢性乙型肝炎（乙肝）患者采用核苷类似物治疗疗效,并观察其对患者肝细胞内HBVcccDNA、tDNA及血清HBsAg的影响。[方法]将我院2014年2月-2015年3月入院治疗的136例乙肝患者按照随机抽签法分组为对照组（注射用重组干扰素α-1b）与观察组（于对照组治疗基础上加用拉米夫定）,各68例。检测2组患者治疗前后肝细胞内HBVcccDNA、tDNA及血清HBsAg水平,并监测2组患者治疗前后肝功能各项指标变化,统计2组患者HBV DNA及HBeAg变化情况,观察2组患者治疗期间不良反应情况。[结果]经治疗后,2组患者肝细胞内HBVcccDNA、tDNA及血清HBsAg水平均下降,且观察组下降较对照组显著（P〈0.05）;2组患者治疗后各项肝功能指标水平均较治疗前明显下降,且观察组下降更显著（P〈0.05）。观察组HBV DNA和HBeAg转阴率及HBeAg血清转换率均明显高于对照组（P〈0.05）。治疗期间均无明显不良反应。[结论]应用核苷类似物拉米夫定辅助治疗慢性乙型肝炎患者疗效显著且安全。

[Objective]To study the influence of nucleoside analogyue on hepatitis B virus cccDNA,tNDA and serum HBsAg in chronic hepatitis B patients and observe its clinical efficacy.[Methods]136patients with chronic hepatitis B from February 2014 to March 2015 in our hospital were divided into control group injection of recombinant interferonα-1band observation group on the basis of the control group combined with lamivudine.Each group had 68 cases.HBsAg levels and liver function,the HBV cccDNA,tDNA within liver cells and serum of all patients,were detected before and after treatment.Changes of HBV DNA and HBeAg in 2groups of patients were statistically analyzed.Adverse reactions were observed during the treatment.[Results]After the treatment,the HBV cccDNA,tDNA in liver cells,serum HBsAg and liver function decreased,and the observation group was significantly lower than the control group（P〈0.05）;The negative rates of HBV DNA,HBsAg and the seroconversion rates of HBsAg in observation group were significantly higher than those in control group（P〈0.05）.No significant adverse reactions were noted during the whole treatment.[Conclusion]The application of nucleoside analogue lamivudine adjuvant therapy in patients with chronic effect has significant and safe curative effect.