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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].现代生物医学进展英文版,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
  
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
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Author NameAffiliation
田群1 左维泽1 曹玉文2 朱庆峰1 季榕1 詹爱琴1 石河子大学医学院第一附属医院感染科 
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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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