聚乙二醇干扰素α-2b联合替诺福韦对乙型肝炎患者肝功能及安全性的影响

Effect of Peginterferon Alpha-2b Combined with Tenofovir on Liver Function and Safety in Patients with Hepatitis B

目的:探讨聚乙二醇干扰素α-2b联合替诺福韦对乙型肝炎患者肝功能及安全性的影响。方法:选取2018年10月—2020年8月南阳医学高等专科学校第一附属医院收治的96例乙型肝炎患者作为研究对象,采用乱数表法分为A组和B组,每组各48例。A组给予替诺福韦酯片治疗,B组在A组基础上加用聚乙二醇干扰素α-2b治疗。比较两组患者治疗前、后总胆红素(TBIL)、白蛋白(ALB)、天门冬氨酸氨基转移酶(AST)、谷丙转氨酶(ALT)、干扰素-γ(IFN-γ)、白介素-10(IL-10)、白介素-4(IL-4)和白介素-2(IL-2)水平。比较两组患者乙型肝炎病毒(HBV)-DNA转阴率、乙型肝炎e抗原(HBeAg)转阴率、转换率和ALT复常率。统计两组患者治疗有效率和不良反应发生率。结果:治疗后,B组总胆红素(TBIL)、天门冬氨酸氨基转移酶(AST)和谷丙转氨酶(ALT)水平均低于A组,两组患者白蛋白(ALB)均升高且B组升高幅度大于A组,差异有统计学意义(t=15.629、27.253、30.580、11.761,P<0.05);治疗后,两组患者酶联免疫吸附测定干扰素-γ(IFN-γ)和白介素-2(IL-2)均升高,且B组升高幅度大于A组,白介素-10(IL-10)和白介素-4(IL-4)均降低,且B组降低幅度大于A组,差异有统计学意义(t=20.777、7.614、24.624、1.609,P<0.05);B组HBV-DNA转阴率、ALT复常率、乙型肝炎e抗原(HBeAg)转阴率、HBeAg转换率均高于A组,差异有统计学意义(χ^(2)=4.381、4.800、4.019、4.909,P<0.05);B组治疗总有效率高于A组,差异有统计学意义(χ^(2)=4.360,P<0.05);两组患者不良反应发生率比较,差异无统计学意义(χ^(2)=0.079,P>0.05)。结论:聚乙二醇干扰素α-2b联合替诺福韦可有效改善患者肝功能,调节免疫功能且安全性较高。

Objective:To explore the effect of peginterferonα-2b combined withtenofovir on liver function and safety in patients with hepatitis B.Methods:96 patients with hepatitis B admitted to the hospital from October 2018 to August 2020 were randomly divided into group A and group B,with 48 cases in each group.Group A was treated with tenofovir dipivoxil tablets,and group B was treated with pegylated interferon on the basis of group A withα-2b treatment.Total bilirubin(TBIL),albumin(ALB),aspartate aminotransferase(AST),alanine aminotransferase(ALT)and interferon of the two groups before and after treatment-γ(IFN-γ),interleukin-10(IL-10),interleukin-4(IL-4)and interleukin-2(IL-2)before and after treatment were compared.The negative rate of hepatitis B virus(HBV)DNA,hepatitis B e antigen(HBeAg),conversion rate and ALT normalization rate were compared between the two groups.The effective rate and adverse reaction rate of the two groups were counted.Results:After treatment,the levels of TBIL,AST,ALT,IL-10 of B group were lower than A group.Albumin(ALB)was increased in both groups,and the increase in group B was greater than that in group A,with statistically significant difference(t=15.629,27.253,30.580,11.761;P<0.05).After treatment,the increase of IFN-γand IL-2 of B group was higher than A group,IL-10 and IL-4 decreased,and the level of B group was greater than A group,with statistically significant difference(t=20.777,7.614,24.624,1.609;P<0.05).The HBV DNA negative conversion rate,ALT normalizing rate,hepatitis Be antigen(HBeAg)negative conversion rate and HBeAg conversion rate in group B were higher than those in group A,and the differences were statistically significant(χ^(2)=4.381,4.800,4.019,4.909,P<0.05).The total effective rate of group B was higher than that of group A,and the difference was statistically significant(χ^(2)=4.360,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.079,P>0.05).Conclusion:Pegylated interferonα-2b combined with tenofovir can effectively improve liver function,regulate immune function and have high safety.