摘要
目的分析干扰素(IFN)脉冲与全程疗法治疗干预核苷类似物(恩替卡韦或替诺福韦)经治低水平乙肝表面抗原(HBsAg)慢性乙型肝炎的临床疗效。方法选择广东省茂名市人民医院2016年1月至2018年1月门诊治疗的40例低水平HBsAg慢性乙型肝炎患者,按随机数字表法分组,每组各20例,参照组应用核苷类似物治疗,试验组在核苷类似物给药基础上应用聚乙二醇干扰素a(2b)(IFNa-2b)脉冲治疗,对比两组肝纤维化指标、丙氨酸氨基转移酶(ALT)复常率、HBsAg转阴率、乙型肝炎病毒(HBV DNA)应答率。结果试验组治疗6个月后Ⅳ型胶原(CIV)、Ⅲ型前胶原蛋白肽(PⅢP)、层粘连蛋白(LN)、透明质酸(HA)均低于参照组,试验组治疗12、24、48周ALT复常率(60.00%、70.00%、85.00%)、HBsAg转阴率(55.00%、75.00%、85.00%)均高于参照组ALT复常率(25.00%、35.00%、55.00%)、HBsAg转阴率(20.00%、35.00%、50.00%),试验组HBV DNA高度应答率(70.00%)高于参照组(35.00%),差异有统计学意义(P<0.05)。试验组HBV DNA中度、轻度应答率(20.00%、10.00%)与参照组(40.00%、25.00%)比较,差异无统计学意义(P>0.05)。结论IFN脉冲与全程疗法可有效改善经核苷类似物治疗低水平HBsAg慢性乙型肝炎患者肝纤维化,提高ALT复常率、HBsAg转阴率、HBV DNA高度应答率。
Objective To analyze the clinical efficacy of interferon(IFN)pulse and whole course therapy for intervention on low-level hepatitis B surface antigen(HBsAg)chronic hepatitis B after nucleoside analogue(entecavir or tenofovir)treatment.Methods The research objects were 40 patients with low-level HBsAg chronic hepatitis B treated in Maoming People's Hospital from January 2016 to January 2018.They were grouped by random number table method,with 20 cases in each group.The reference group was treated with nucleoside analogues,while the experimental group was treated with polyethylene glycol interferon A(2b)(IFNA-2b)pulse therapy on the basis of nucleoside analogues.The liver fibrosis index,the alanine aminotransferase(ALT)normalization rate,the HBsAg negative conversion rate and the response rate of hepatitis B virus(HBV DNA)were compared between the two groups.Results After 6 months of treatment,the levels of type IV collagen(CIV),typeⅢprocollagen peptide(PⅢP),laminin(LN)and hyaluronic acid(HA)in the experimental group were lower than those in the reference group.The ALT normalization rate(60.00%,70.00%,85.00%)and HBsAg negative conversion rate(55.00%,75.00%,85.00%)in the experimental group at 12,24 and 48 weeks of treatment were higher than the ALT normalization rate(25.00%,35.00%,55.00%)and HBsAg negative conversion rate(20.00%,35.00%,50.00%)in the reference group.The high response rate of HBV DNA in the experimental group(70.00%)was higher than that in the reference group(35.00%).There were statistically significant differences in the above-mentioned indexes(P<0.05).There were no statistically significant differences in the moderate and mild response rates of HBV DNA(20.00%,10.00%)in the experimental group and those in the reference group(40.00%,25.00%)(P>0.05).Conclusion IFN pulse and whole course therapy can effectively improve liver fibrosis in patients with low-level HBsAg chronic hepatitis B treated by nucleoside analogues,and increase ALT normalization rate,HBsAg negative conversion rate,and high respons
作者
杨智娟
易海宁
占玮
李耀才
陈春
YANG Zhijuan;YI Haining;ZHAN Wei;LI Yaocai;CHEN Chun(Department of Infectious Diseases,the Maoming People's Hospital,Guangdong,Maoming 525000,China)
出处
《中国医药科学》
2021年第15期237-240,共4页
China Medicine And Pharmacy
