白细胞介素2联合恩替卡韦初始治疗重症慢性乙型肝炎的疗效观察

Observation on Efficacy of Interleukin-2 Combined with Entecavir in Initial Treatment of Severe Chronic Hepatitis B

目的:探讨白细胞介素2联合恩替卡韦初始治疗重症慢性乙型肝炎的临床疗效。方法:选取2015年1月至2017年6月江西省石城县人民医院收治的重症慢性乙型肝炎患者100例作为研究对象,采用随机数字表法分为观察组与对照组,每组50例。对照组患者给予常规基础治疗联合口服恩替卡韦片,观察组患者在对照组的基础上加用白细胞介素2。观察两组患者的血清总胆红素(TBIL)、天门冬氨酸氨基转移酶(AST)和丙氨酸氨基转移酶(ALT)复常情况及乙型肝炎病毒(hepatitis B virus,HBV)DNA转阴情况,治疗费用、远期疗效及不良反应发生情况。结果:住院治疗期间,观察组患者TBIL、ALT复常率及HBV DNA转阴率明显高于对照组,差异均有统计学意义(P<0.05),但AST复常率低于对照组;两组患者平均住院时间、平均治疗费用、日均治疗费用、平均药物费用及日均药物费用的差异均无统计学意义(P>0.05);抗病毒治疗24、48和96周后,两组患者AST、ALT复常率及HBV DNA转阴率的差异均无统计学意义(P>0.05);两组患者不良反应发生率的差异无统计学意义(P>0.05)。结论:白细胞介素2联合恩替卡韦初始治疗重症慢性乙型肝炎,短期内的TBIL、ALT复常率及HBV DNA转阴率改善明显,且经济实惠,安全性高,但远期疗效有待于进一步考察。

OBJECTIVE： To probe into the clinical efficacy of interleukin-2 combined with entecavir in initial treatment of severe chronic hepatitis B. METHODS： 100 patients with severe chronic hepatitis B admitted into Shicheng People＇s Hospital from Jan. 2015 to Jun. 2017 were selected and divided into observation group and control group via random number table,with 50 cases in each. The control group was given conventional therapy combined with Entecavir tablets orally,while the observation group was given interleukin-2 based on the control group. The recovery rates of total bilirubin（ TBIL）,aspartate amino transferase（ AST） and alanine aminotransferase（ ALT）,the negative conversion rate of DNA of hepatitis B virus,treatment expense,long-term efficacy and incidences of adverse drug reactions of two groups were observed. RESULTS： During hospital stays,the recovery rates of TBIL,ALT and the negative conversion rate of HBV DNA of observation group were significantly higher than those of the control group,with statistically significant differences（ P〈0. 05）,while the recovery rate of AST of observation group was lower;there were no statistical significance in differences of average hospital stays,average treatment expenses,daily treatment expenses,average drug costs and daily drug costs between two groups（ P〉0. 05）; at 24 weeks,48 weeks and 96 weeks after antiviral therapy,there were no statistical significance in differences of the recovery rates of TBIL,AST and the negative conversion rate of HBV DNA between two groups（ P〉0. 05）; there were no statistical significance in difference of incidences of adverse drug reactions between two groups（ P〉0. 05）. CONCLUSIONS：The combination of interleukin-2 and entecavir in initial treatment of severe chronic hepatitis B can significantlyimprove the recovery rates of TBIL,ALT and the negative conversion rate of HBV DNA,which is safe,economical and practical,while the long-term efficacy remains further investigation.