恩替卡韦联合聚乙二醇干扰素α-2b治疗HBeAg阳性乙肝的临床研究

Clinical Study of Entecavir Combined with Peginterferon α-2b in the Treatment of HBeAg Positive Hepatitis B

目的:探讨恩替卡韦联合聚乙二醇干扰素α-2b治疗乙型肝炎E抗原(HBeAg)阳性乙肝的临床疗效、安全性及对相关标志物的影响。方法:选取2015年10月至2017年10月我院收治的97例HBeAg阳性乙肝患者,采用随机数字表法将其分为对照组48例和观察组49例。对照组患者采用单纯皮下注射聚乙二醇干扰素α-2b注射剂治疗,观察组采用恩替卡韦联合聚乙二醇干扰素α-2b治疗。比较两组患者治疗后的临床疗效、谷草转氨酶(AST)、丙氨酸转氨酶(ALT)、乙肝病毒的脱氧核糖核酸(HBV-DNA)含量以及ALT复常率、HBeAg血清转换率、HBV-DNA转阴率及不良反应发生率。结果:观察组总治疗有效率为91.84%,明显高于对照组的77.55%(P<0.05);治疗后,观察组的ALT、AST、HBV-DNA含量明显低于对照组(P<0.05),观察组的ALT复常率、HBeAg血清学转换率、HBV-DNA转阴率明显高于对照组(P<0.05);观察组治疗期间不良反应发生率为30.61%,与对照组的29.17%比较差异无统计学意义(P>0.05)。结论:恩替卡韦联合聚乙二醇干扰素α-2b治疗HBeAg阳性乙肝较单用干扰素的抗病毒治疗疗效更高,可降低传染性,用药安全性较好。

Objective:To investigate the the clinical efficacy,safety and effects of entecavir combined with peginterferonα-2 b in the treatment of hepatitis B E antigen(HBeAg)positive hepatitis B.Methods:97 cases of HBeAg positive hepatitis B patients enrolled in our hospital from October 2015 to October 2017 were divided into control group(n=48)and observation group(n=49)by random number table methods.The control group was treated with subcutaneous injection of peginterferonα-2 b,while the observation group was treated with entecavir combined with peginterferon alpha-2 b.The clinical efficacy,the content of aspartate aminotransferase(AST),alanine aminotransferase(ALT)and hepatitis B virus DNA(HBV-DNA),the conversion rate of HBeAg serological,the seroconversion rate of hepatitis B virus deoxyribonucleic acid(HBV-DNA),and the incidence of adverse reactions of the patients in the two groups after treatment was compared.Results:The total effective rate of observation group was 91.84%,which was significantly higher than that of control group(x2=8.50,P<0.05).After treatment,the contents of ALT,AST and HBV-DNA in observation group was significantly lower than those in control group(P<0.05),the repetition rate of ALT,the conversion rate of HBeAg serological,the seroconversion rate of HBV-DNA rate was significantly higher than those of the control group(P<0.05).After treatment,the incidence of adverse reactions in the observation group was 30.61%,compared with 29.17%in the control group,the difference was not statistically significant(P>0.05).Conclusion:The efficacy of entecavir combined with peginterferonα-2 b in the treatment of HBeAg positive hepatitis B is better than that of interferon alone,it can reduce the contagiousness and has a good safty.