PEG-IFN-α-2b联合恩替卡韦对慢性乙型肝炎病毒高载量患者临床效果研究

Effect of PEG-IFN-α-2b combined with entecavir in the treatment of patients with high-viral-load chronic hepatitis B

目的探讨PEG-IFN-α-2b联合恩替卡韦对慢性乙型肝炎(乙肝)病毒高载量患者临床效果观察及对患者肝功能影响。方法选取温州市中医院于2016年3月~2018年3月期间收治的慢性乙肝病毒高载量患者82例,采用随机数字表法随机分为对照组41例与观察组41例。对照组患者采用恩替卡韦治疗;观察组在对照组基础上联合PEG-IFN-α-2b治疗。两组疗程均为12个月。比较两组治疗3个月、6个月和12个月血清HBV DNA检测率、HBeAg血清转换率、HBsAg阴转率;治疗前、治疗3个月、6个月和12个月肝功能指标变化,及治疗期间不良反应发生情况。结果观察组治疗3个月、6个月和12个月血清HBVDNA检测率高于对照组,差异有统计学意义(P<0.05);观察组治疗3个月、6个月和12个月HBeAg血清转阴率高于对照组,差异有统计学意义(P<0.05)。两组治疗3个月、6个月和12个月HBsAg阴转率比较差异无统计学意义(P>0.05);两组治疗3个月、6个月和12个月血清AST和ALT水平较治疗前降低(P<0.05);观察组治疗3个月、6个月和12个月血清AST和ALT水平低于对照组(P<0.05);两组发生不良反应率比较差异无统计学意义(P>0.05)。结论 PEG-IFN-α-2b联合恩替卡韦对慢性乙肝病毒高载量患者临床效果良好,可改善患者肝功能。

Objective To observe the clinical effect of PEG-IFN-α-2 b along with entecavir in the treatment of patients with high-viral-load chronic hepatitis B(CHB), and to discuss the impact on liver function. Methods A total of 82 patients with high-viral-load CHB admitted to our hospital from March 2016 to March 2018 were enrolled and randomly divided into control group(41 cases) and observation group(41 cases) by random number table method.Patients in the control group were treated with entecavir, while those in the observation group also received PEG-IFN-α-2 b treatment for 12 months.The serum HBV DNA undetectable rate, HBeAg seroconversion rate, HBsAg negative conversion rate, changes of liver function parameters before treatment as well as 3 months, 6 months and 12 months after treatment, and adverse reactions during treatment were compared between the two groups. Results The serum HBV DNA undetectable rate and HBeAg seroconversion rate in the observation group were higher than those in the control group at 3, 6 and 12 months after treatment, the differences were statistically significant(P<0.05).There was no significant difference in HBsAg negative conversion rate between the two groups at 3, 6 and 12 months after treatment(P>0.05).The serum levels of AST and ALT reduced in both groups after treatment at each time point(P<0.05), while the levels in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusions PEG-IFN-α-2 balong with entecavir is more effective than entecavir alone in treating patients with high-viral-load CHB,which can greatly improves the liver function of patients.