聚乙二醇干扰素α-2b治疗61例e抗原阳性慢性乙型肝炎临床分析

目的探讨聚乙二醇化干扰素α-2b治疗e抗原(HBeAg)阳性慢性乙型肝炎的临床疗效和不良反应,同时探讨影响应答的相关因素。方法用聚乙二醇干扰素α-2b治疗61例HBeAg阳性慢性乙型肝炎,治疗期间定期监测血常规、生物化学指标、病毒学标志、甲状腺功能等。结果 48周,表面抗原(HBsAg)和HBeAg血清学转换率分别为5.26%、31.2%;血清HBV DNA阴转率为59.6%;ALT复常率为64.9%。随访半年,HBV DNA复发率为17.4%;HBeAg血清学转换者维持应答。治疗前ALT>5 ULN时,48周时HBeAg血清学转换率和HBV DNA阴转率明显高于ALT<5 ULN时,二者比较差异有统计学意义;而血清HBV DNA水平与其无明显相关性。结论聚乙二醇化干扰素α-2b具有免疫调节和抗病毒双重作用,48周时HBeAg血清学转换率和HBV DNA阴转率与治疗前血清ALT水平与相关,停药后具有持续应答效应。

The clinical analysis of PEG-interferon alpha-2b therapy in 61 cases of HBeAg-positive chronic hepatitis B

Objective To investigate the clinical curative effect and adverse reaction of PEG-interferon alpha-2b therapy in HBeAg-positive chronic hepatitis B, and discuss the influence factors. Method 61 cases of HBeAg-positive chronic hepatitis B were treated with PEG-imerferon alpha-2b. During the treatment, indicators such as blood routine, bio- chemistry indexes, virology marks and thyroid function were regularly monitored. Result At week 48, HBsAg and HBeAg serological conversion were 5.26% and 31.2% respectively ; 59.6% patients had HBV DNA negative result, and 64.9% patients had ALT normalization. At the end of half year follow-up, the recurrence rate of HBV DNA was 17.4% ; HBeAg serological conversion maintained response. When ALT 〉 5 ULN before treatment, the HBeAg serological conversion and HBV DNA negative rate were obviously higher than those when ALT 〈 5 ULN; Serum HBV DNA level was not obviously related. Conclusion PEG-Interferon alpha-2b has the function of immune adjustment and antiviral effect, The serum ALT level before treatmem is associated with the HBeAg serological conversion and HBV DNA negative rate at Week 48. After discontinuation, PEG-interferon alpha-2b keeps sustained response.