摘要
目的观察拉米夫定治疗慢性乙型肝炎失败者干扰素-α2b再治疗的远期疗效。方法125例拉米夫定治疗慢性乙型肝炎失败者中84例接受干扰素-α2b再治疗、5Mu/d,1月后改为隔日1次,疗程6个月;21例继续接受拉米夫定治疗,20例接受一般护肝治疗。观察患者治疗前、治疗后1个月、3个月、6个月1、2个月、24个月、36个月肝功能、乙型肝炎病毒血清标志物、HBV DNA、YMDD变异情况。结果治疗结束时,干扰素组患者HBV DNA阴转率及HBeAg阴转率分别为46.4%和40.5%;拉米夫定治疗组分别为19.0%和9.5%,护肝治疗组均为5.0%,干扰素组与其他两组在统计学上有显著差异(P<0.05)。36个月随访结束时,干扰素组、拉米夫定组和保守治疗组的综合应答率分别为17.8%、9.5%、10.0%,无统计学差异(P<0.05)。拉米夫定组YMDD变异达76.2%,而另两组YMDD变异分别为3.6%和5%。结论拉米夫定治疗失败者仍可选用干扰素抗病毒治疗,但远期疗效较差。
Objective To evaluate the long-term outcome of interferon α-2b in the treatment of patients with chronic hepatitis B （CHB）failed to lamivudine therapy. Methods The eighty-four patients amomg 125 cases with CHB failed to lamivudine received interferon α-2b,5Mu daily for the first month, then every other day for 5 months. The patients＇s liver function test, serum hepatitis B virus markers, serum HBV DNA and YMDD mutant were detected before treatment, at the first month, third month, sixth month, twelf/th month, twenty-fourth month and thirty-sixth month after the treatment. Results At the end of the sixth month, the rate of HBV DNA and of HBeAg loss in the patients treated with interferon α-2b were 46.4% and 40.5% ,respectively,much higher than 19.0% and 9.5% in lamivudine and 5.0% and 5.0% in control. At the end of 3-year＇s follow up, the rates of combined response to interferon α-2b, lamivu- dine and control were 17.8%, 9.5% and 10%, respectively （ P 〉 0. 05）. The rate of YMDD mutation in the patients treated with lamivudine was 76.2 % at the end of follow up, and that in other two groups were 3.6 % and 5.0 %. Coneluslon These results indicate that patients with CHB failed to lamivudine could have interferon α-2b therapy but the long-term efficacy is unsatisfactory.
出处
《实用肝脏病杂志》
CAS
2005年第6期337-339,共3页
Journal of Practical Hepatology
关键词
乙型肝炎
拉米夫定
干扰素
远期疗效
Hepatitis B
Lamivudine
Interferon α-2b long-term outcome
