摘要
目的分析比较应用干扰素α(IFN-α)和核苷(酸)类似物(NAs)治疗对慢性乙型肝炎患者肝细胞癌(HCC)发生率的影响差异。方法 2007年1月~2010年12月收治的30岁~60岁慢性乙型肝炎(CHB)患者,接受IFN-α2b治疗210例,治疗48~72 w,接受NAs治疗222例,长期应用和未抗病毒组136例。随访6年,观察疗效和HCC发生情况。应用SPSS 19.0统计软件分析。结果在治疗72周末,IFN-α2b治疗组HBe Ag阳性患者比率显著低于NAs治疗组或未抗病毒组(P均<0.05),但NAs治疗患者血清HBV DNA和ALT水平显著低于IFN-α2b治疗组或未抗病毒组(P均<0.05);IFN-α2b治疗组与NAs治疗组血清肝纤维化标志物变化无显著性差异(P均>0.05),但均比未抗病毒组低(P均<0.05);随访6年,未抗病毒组HCC发生率为16.91%(23/136),显著高于NAs治疗组的9.46%(21/222,x^2=4.345,P=0.037)或IFN-α2b治疗组的0.0%(0/210,x^2=38.044,P=0.000),NAs治疗组HCC发生率显著高于IFN-α2b治疗组,具有统计学差异(x^2=20.880,P=0.000)。结论 IFN-α2b和NAs抗病毒治疗均具有阻断HCC发生的作用,但IFN-α2b治疗在阻断HCC发生方面作用更强。
Objective The aim of this study is to compare the impact of interferon alpha and nucleos（t）ide analogues in treating patients with chronic hepatitis B on incidence of hepatocellular carcinoma. Methods A series of patients with chronic hepatitis B （CHB） aged 30 to 60 years old were enrolled between January 2007 and December 2010 in our hospital. 210 patients with CHB were treated with interferon alpha 2b （IFN-α2b） for 72 weeks, 222 with nucleos （t）ide analogues （NAs） as a long-term treatment and 136 cases didn＇t received antiviral therapy. All the patients were followed-up for six years. All data were analyzed by SPSS 19.0 statistics software. Results At the end of 72 week treatment,serum HBeAg positivity rate in IFN-α2b-treated group was much lower than in NAs-treated or in non-antiviral group （P〈0.05）,while serum HBV DNA and alanine aminotransferase levels in NAs-treated group were much lower than in IFN-α2b-treated group or in non-antiviral group （P〈0.05）;serum chileglycine,collagen peptide Ⅲ,Ⅳ collagen,hyaluronic acid and laminin levels in IFN-α2b-or NAs-treated group were not significantly different （P〉0.05）,while all were much lower than in non-antiviral group （P〈0.05）;At the discontinuation of six year follow-up,the incidence of HCC in non-antiviral group was 16.91%（23/136）,much higher than 9.46%（21/222,x2=4.345,P=0.037） in NAs-treated or 0.0% （0/210,x2=38.044,P=0.000） in IFN-α2b-treated group,and the incidence of HCC in NAs-treated group was much higher than in IFN-α2b-treated group （x2=20.880,P=0.000）. Conclusions The efficacy of IFN-α2b therapy on HCC occurrence in patients with CHB is much stronger than NAs treatment.
出处
《实用肝脏病杂志》
CAS
2017年第4期455-459,共5页
Journal of Practical Hepatology
