| 田群1 左维泽1 曹玉文2 朱庆峰1 季榕1 詹爱琴1.拉米夫定与IFNα-1b 序贯治疗HBeAg 阳性慢性乙肝患者临床疗效观察[J].,2011,11(19):3694-3696 |
| 拉米夫定与IFNα-1b 序贯治疗HBeAg 阳性慢性乙肝患者临床疗效观察 |
| Clinic Efficacy of Sequential Therapy with Lamivudine and RecombinantHuman Interferon α-1b Combination Compared to Lamivudine orRecombinant Human Interferon α-1b Monotherapy in HBeAg PositiveChronic Hepatitis B Patients |
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| DOI： |
| 中文关键词: 慢性乙肝 序贯治疗 拉米夫定 干扰素α-lb HBV-DNA |
| 英文关键词: Chronic hepatitis B Sequential therapy Lamivudine Interferon-α1b HBV-DNA |
| 基金项目: |
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| 中文摘要: |
| 目的：观察比较拉米夫定联合IFNα-1b 的序贯疗法与拉米夫定、IFNα-1b 的单药疗法在治疗HBeAg 阳性的慢性乙型肝炎
方面的疗效差异。方法：将98 例HBeAg 阳性慢乙肝患者随机分为序贯治疗组、拉米夫定治疗组和IFNα-1b 治疗组。序贯治疗组
33 例，年龄37.85±7.70 岁，男/ 女:18/15，首先使用拉米夫定(100mg 一日一次口服疗程24 周)，序贯使用IFNα-1b(60ug 隔日一
次皮下注射疗程28 周)，在第20 周至24 周同时使用拉米夫定和IFNα-1b，总疗程48 周；拉米夫定治疗组34 例，年龄39.42±
6.88 岁，男/ 女:20/14，仅口服拉米夫定，100mg 一日一次口服，疗程48 周；IFNα-1b 治疗组31 例，年龄35.71±6.14 岁，男/ 女:
14/17，仅皮下注射IFNα-lb，60ug 隔日一次，疗程48 周。治疗12 周、24 周、48 周时检测肝功能、乙肝两对半、HBV-DNA 等指标变
化。结果：在治疗12 周、24 周时三组间肝功复常率、HBeAg 阴转率无差异，序贯治疗组、拉米夫定组HBV-DNA 阴转率优于
IFNα-1b 治疗组；实验疗程结束时序贯治疗组HBeAg 阴转率、抗-HBe 转换率及HBV-DNA 阴转率显著高于其他两组，P<0.05，
但在HBV-DNA 阴转率方面序贯治疗组与拉米夫定治疗组差异不显著。结论：拉米夫定和IFNα-lb 序贯疗法在HBV-DNA 阴转
率、HBeAg 阴转率和抗HBe 转换率三方面的疗效优于拉米夫定、IFNα-lb 单一用药。 |
| 英文摘要: |
| Objective: To compare the efficacy of sequential lamivudine and IFNα-lb therapy versus lamivudine or IFNα-lb
monotherapy in HBeAg positive chronic hepatitis B patients. Methods: 98 CHB with HBeAg positive patients were randomly divided
into three groups: observation group was treated with combined lamivudine and IFNα-lb, (n=33，age:37.85 ±7.70 years old，
Male/Female:18/15)received lamivudine (100 mg qd po)monotherapy from 1st day to 24th weeks，then added IFNα-lb (6 MIU qod ih）
from 20th weeks to 48weeks; lamivudine group (n=34，age:39.42±6.88 years old，Male/Female:20/14）was treated with lamivudine for
48 weeks; IFNα-lb group (n=31，age:35.71±6.14 years old，Male/Female:14/17）was treated with IFNα-lb(6 MIU qod ih)for 48 weeks.
Exam the liver function, HBsAg,HBsAb,HBeAg,HBeAb,HBcAb and HBV-DNA at 12th weeks,24th weeks and 48th weeks. Results: The
rates of liver function normalization and HBeAg loss were not statistically significant among three groups at 12th and 24th weeks,but rate
of HBV-DNA suppression (<1000 copies／m1)in observation group and lamivudine group were higher significant than IFNα-lb group ,
P<0.05; Rates of HBeAg loss and anti-HBe appearance in sequential therapy group were higher significant than other groups at end of
experiment ,P<0.05; but the rate of HBV-DNA suppression(<1000 copies／m1) wasn't statistically significant between observation group
and lamivudine group. Conclusions: The results demonstrate that sequential therapy is superior to lamivudine or IFNα-lb monotherapy
in rates of HBV-DNA suppression, HBeAg loss and anti-HBe appearance. |
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