Peg-IFNa-2b单药与联合NAs治疗HBeAg阳性慢乙肝初治患者的疗效比较

Comparison of the Efficacy on Peg-IFNa-2b Monotherapy and NAs Combined Therapy in Patients with HBeAg Positive Chronic Hepatitis B

目的比较聚乙二醇干扰素α-2b(Peg-IFNa-2b)单药治疗与联合核苷(酸)类药物(NAs)治疗HBeAg阳性初治慢性乙型肝炎(CHB)的疗效差异。方法收集2017年1月-2020年12月就诊于深圳市第三人民医院的HBeAg阳性CHB初治患者共69例,根据治疗方案分为单药治疗组(30例)和联合治疗组(39例),单药治疗组单用Peg-IFNa-2b治疗,联合治疗组以Peg-IFNa-2b联合NAs治疗,比较两组治疗12、24、48周的HBV DNA转阴率、HBeAg转阴率、HBsAg下降值、ALT复常率、eGFR下降等情况差异。结果联合治疗组24、48周的HBV DNA转阴率高于单药治疗组,差异有统计学意义(P<0.05);两组HBeAg转阴率、HBsAg下降值、ALT复常率、eGFR变化比较,差异无统计学意义(P>0.05)。结论与单用Peg-IFNa-2b相比,联合核苷(酸)类治疗可提高HBeAg阳性慢性乙型肝炎患者病毒学应答率。

Objective To compare the efficacy of pegylated interferonα-2b(Peg-IFNa-2b)alone and combined with nucleoside analogues drugs(NAs)in the treatment of HBeAg-positive chronic hepatitis B(CHB).Methods A total of 69 patients with HBeAg-positive CHB who were treated in Shenzhen Third People's Hospital from January 2017 to December 2020 were enrolled.According to the treatment plan,they were divided into single drug treatment group(30 cases)and combined treatment group(39 cases).The single drug treatment group was treated with Peg-IFNa-2b alone,and the combined treatment group was treated with Peg-IFNa-2b combined with NAs.The negative conversion rate of HBVDNA,negative conversion rate of HBeAg,decline of HBsAg,normalization rate of ALT and decline of eGFR were compared between the two groups at 12,24 and 48 weeks of treatment.Results The negative conversion rate of HBVDNA in the combined treatment group at 24 and 48 weeks was higher than that in the single drug treatment group,and the difference was statistically significant(P<0.05);there was no significant difference in HBeAg negative conversion rate,HBsAg decline,ALT normalization rate and eGFR between the two groups(P>0.05).Conclusion Compared with Peg-IFNa-2b alone,combined nucleoside(acid)therapy can improve the virological response rate of HBeAg positive chronic hepatitis B patients.