干扰素联合拉米夫定治疗e抗原阳性的HBV患者临床疗效分析

Analysis of Clinical Effect of Interferon and Lamivudine on the Patients with e Positive HBV

目的分析e抗原阳性的HBV患者应用干扰素联合拉米夫定治疗的临床效果。方法回顾分析本院自2012年7月至2014年7月本科室治疗的105例e抗原阳性HBV患者的临床资料,将应用拉米夫定治疗的患者52例列为对照组,拉米夫定联合应用聚乙二醇干扰素的53名患者列为研究组,疗程均为12个月。观察对比两组疗效,并对比两组治疗前后HBV DNA、HBV抗原转阴率,谷丙转氨酶(ALT)水平,及治疗期间不良反应发生率的差异。结果在总有效率方面,与对照组的82.69%相比,研究组总有效率显增高为92.45%(P<0.05);在各指标变化方面,与对照组相较,研究组HBe Ab/HBe Ag转换率、HBs Ag阴转率、HBV DNA阴转率均呈明显增高(P<0.05)。ALT水平在治疗3个月、12个月后,研究组显著低于对照组(P<0.05)。两组不良反应发生率无差别。结论 e抗原阳性HBV患者应用干扰素联合拉米夫定治疗,可以改善血清ALT、HBV DNA水平,提高HBe Ab/HBe Ag转换率、HBs Ag及HBV DNA阴转率,不良反应少,安全有效,应予推广。

Objective To analyse the clinical effect of interferon and lamivudine on the patients with e positive HBV. Methods Clinical data of 105 patients with e antigen positive HBV in our hospital from Jul 2012 to Jul 2014 were retrospectively analyzed.The patients treated with lamivudine served as the control group （n = 52）, and the patients treated with pegylated interferon and lamivudine served as research group （n= 53）.All patients were treated for 12 months.The cur- ative effect was observed, HBV DNA, HBV antigen seroeonversion rate ,the level of alanine aminotransferase （ALT） and the adverse reaction incidence were compared. Results Compared with the total effective rate 82.69% of control group, the research group had a higher total effective rate （ 92.45%, P〈0.05 ）.The negative transfer rate of HBeAb/HBeAg, HBsAg, HBV DNA,were significantly higher in the research group （P〈0.05）.Compared with the control group,the ALT level was lower after treatment for 3 months, 12 months （P〈0.05）.The adverse reaction in duration of treatment in the two groups is not different. Conclusion HBV e antigen positive patients treated with interferon combined with lamivudine therapy can improve the serum ALT, HBV DNA level, HBeAb/HBeAg conversion rate, HBsAg and HBV DNA negative conversion rate, with less adverse reaction, which is safe, effective, and worthy of being popularized.