干扰素联合阿德福韦酯序贯替比夫定治疗HBeAg阳性慢性乙型肝炎效果

Curative effect of interferon combined withadefovirdipivoxilandsequential therapy with telbivudine on HBeAg positive chronic hepatitis B

目的:观察干扰素联合阿德福韦酯序贯替比夫定治疗HBeAg阳性慢性乙型肝炎效果。方法:选择符合条件的HBeAg阳性慢性乙型肝炎患者57例,其中观察组26例采用干扰素联合阿德福韦酯治疗48周之后两者停用,然后序贯替比夫定治疗至72周,对照组31例全程单用替比夫定治疗72周,观察对比两组病人各个时间点的治疗效果。结果:治疗48周时观察组和对照组的HBV-DNA转阴率分别为39.1%、54.8%,而HBeAg血清学转换率分别为34.8%、22.6%;治疗72周时观察组和对照组的HBV DNA转阴率分别为65.2%、74.2%,而HBeAg血清学转换率分别为39.1%、29.0%;观察组和对照组治疗不同时期两组率的比较差异均无统计学意义(P>0.05)。结论:干扰素联合阿德福韦酯序贯替比夫定治疗HBeAg阳性慢性乙型肝炎72周的疗效在HBV DNA转阴率、HBeAg血清学转换率方面并不优于单用替比夫定组。

Objective： To observe the curative effect of interferon combined with adefovir dipivoxil and sequential therapy with telbivudine an HBeAg positive chronic hepatitis B. Methods：57 patients with HBeAg positive chronic hepatitis B were chosen and divided into the observation group （ n =26） and the control group（ n =31 ）. The observation group was treated with interferon combined with adefovir dipivoxil for 48 weeks, followed by sequential therapy with telbivudinetill 72 weeks while the control group was treated with telbivudinc alone for 72 weeks, with the therapeutic effect of the two groups compared. Results：The negative conversion ratio- saf HBV - DNA in the observation group and the control group were 39.1% and 54.8 % respectively after 48 - week treatment while the HBeAg seroconversion rates were 34.8 % and 22.6 % respectively. The negative conversion ratiosof HBV - DNA in the observation group and control group were 65.2 % and 74.2 % respectively after 72 - week treatment while the HBeAg seroconversion rates were 39.1% and 29.0 % respectively. There was no significant difference between the two groups （ P 〉 0.05）. Conclusion： Interferon combined with adefovir dipivoxil and sequential therapy with telbivudinewas not superior to telbivudine alone in the treatment of HBeAg positive chronic hepatitis B for 72 weeks in terms of negative conversion ratiosof HBV - DNA and the HBeAg seroconversion rates.