a-2b干扰素治疗HBeAg阳性慢性乙型肝炎疗效及预测因素临床研究.docVIP

a-2b干扰素治疗HBeAg阳性慢性乙型肝炎疗效及预测因素临床研究【摘要】目的 观察普通a-2b干扰素和聚乙二醇干扰素（PEG-IFN）α-2b治疗HBeAg阳性慢性乙型肝炎的疗效及预测因素分析。方法 选择HBeAg阳性慢性乙型肝炎患者60例，随机给予30例使用安达芬（安徽安科公司生产a-2b干扰素）500万单位， 皮下注射，每周三次； 30例给予Peg-IFNα-2b佩乐能（先灵葆雅公司生产聚乙二醇a-2b干扰素）1.0μg/kg皮下注射，每周一次。疗程均为52周，停药后随访24周。结果 1.治疗结束和随访24周时，普通干扰素组与Peg-IFN组的完全应答率、部分应答率、无应答率及持续应答率均无统计学差异。2. 普通干扰素组治疗早期ALT更易反弹，随访结束时两组ALT复常率无统计学差异。3.治疗第1～4周HBV DNA 明显下降2Log及治疗过程中ALT急性反弹，能取得持久病毒学应答，复发率低。结论两种不同剂型的a-2b干扰素治疗HBeAg阳性慢性乙型肝炎的应答率相似，无显著性差异。快速病毒学应答及ALT急性反弹是干扰素疗效的有效预测因素。 Clinical study of interferon-alpha 2b antiviral therapy for HBeAg positive chronic hepatitis Bpatients 【Abstract】Objective To investigate the efficacy and prediction factors of IFNα-2b with PEG-IFNα-2b in treating HBeAg positive chronic hepatitis Bpatients. Methods sixty HBeAg positive chronic hepatitis Bpatients were enrolled into this study. The patients received IFNα-2b(groupA:5MU SC,three times a week) or PEG-IFNα-2b(group B: 1.0μg/kg body weight, SC,once a week) for 52 weeks,and followed up for 24 weeks. Results 1. complete response, partial response, non-response and sustained response between the two groups had no statistically significance differences at the end of treatment and after follow-up. 2. ALT easier to rebound in IFNα-2b early antiviral treatment , yet normalization rate had no statistically significance differences after follow-up.3. HBV DNA2Log sharply declined in 1～4 weeks, and ALT quick rebound within the course of treatment in patients, Sustained virological response can be achieved and relapse rate is low. Conclusions The efficacy seems to be Similar between the Two different formulations of interferonα-2b treatment for HBeAg positive chronic hepatitis Bpatients. Rapid virological response and ALT quick rebound are effective factors for predicting IFNα-2b therapy response In CHB patients. 【Key words】hepatitis B ;Interferon alpha-2b ; antiviral therapy 为了解普通a-2b干扰素和Peg-IFNα-2b干扰素对HBeAg阳性慢性乙型肝炎患者的疗效，我们观察了60例HBeAg(+)慢性乙型肝炎患者α-2b IFN治疗效果和随访24周的 结果，探讨干扰素抗病毒疗效的预测因素。