聚乙二醇干扰素α-2a治疗慢性乙型肝炎疗程不规范的分析

Antiviral effects of Peg-IFN α-2a by no standardized treatment in patients with chronic hepatitis B

背景：对聚乙二醇干扰素α-2a治疗应答良好的慢性乙型肝炎患者，延长疗程可提高HBsAg消失/血清转换率，达到理想的治疗效果。目的：观察聚乙二醇干扰素α-2a不规范疗程治疗l陧性乙型肝炎的疗效，探讨聚乙二醇干扰素α-2a短时间抗乙肝病毒治疗的作用与意义。方法：纳入应用聚乙二醇干扰素α-2a治疗的慢性乙型肝炎患者34例，皮下注射聚乙二醇干扰素α-2a 180μg，1次／周，检测患者治疗前、治疗3个月时的肝功能、HBV-DNA载量、HBsAg定量。其中23例在因某种原因停止或放弃聚乙二醇干扰素α-2a治疗，检测患者治疗前、停止治疗3—6个月时的肝功能、HBV-DNA载量、HBsAg定量。同时分析各指标的相关性。结果与结论：治疗3个月时，34例患者谷丙转氨酶、谷草转氨酶水平、HBV-DNA载量、HBsAg定量均有不同程度下降，3例出现病毒学应答，未发生生物化学应答；停止治疗后3-6个月，23例患者中2例HBsAg阴转，6例出现持续性病毒学应答，10例表现生物化学应答。整个治疗过程中，谷丙转氨酶与HBV-DNA载量、HBsAg定量无明显相关性（P均〉0．05），HBV-DNA载量与HBsAg定量呈明显相关（P均〈0．01）。结果表明，聚乙二醇干扰素α-2a短时间内对于初治慢乙肝患者抗病毒效果明显，远期生物化学应答率高，可显著降低HBsAg水平，特别是具有较好的远期疗效。

Objective： To evaluate antiviral effects of Peg-IFNα-2a by no standardized treatment in patients with chronic hepatitis B and Explore antiviral treatment meaning and function in short times.Methods 34 chronic hepatitis B patients were collected from inpatient in Sheng Li hospital from Dec 2012-Dec 2015 and subcutaneous injection of 180ug Peg-IFNα-2a were given once weekly. The treatment times was not more than four months. The ALT, AST, HBV-DNA load, quantitative HBsAg Were assessed at baseline, treatment 3 months ,withdrawal three to six months follow-up. Results 34 patients in the treatment of three months, AST ALT levels, HBV-DNA load, HBsAg quantitative are declined different degreely. Three patients （8.82%） show virological response, No one has biochemical response. There are 23 patients not to use any antiviral drugs after Stop treatment 3 to 6 months. There are 2 cases （8.69%） HBsAg loss and 6 patients （26.08%） sustained virological response 10 cases （43.47%） showed biological chemical response. The ALT levels and HBV-DNA load, quantitative HBsAg was not associated.The HBV-DNA load and quantitative HBsAg were associated significantly in the course（r=0.813, P 〈 0.01 ; r=0.728, P 〈 0.01 ; r=0.984, P 〈 0.01）. Conclusion The short time therapy with Peg-IFNα-2a for the response well patients with chronic hepatitis B is obvious, Biological chemical response rate is high forward and reduce the level of HBsAg significantly.