Objective To compare the therapeutic effect of lamivudine interferon sequential therapy and only lamivudine therapy in chronic hepatitis b patients.Methods Randomly selected HbeAg positive chronic hepatitis b 198 cases of patients, including 100 people in the observation group, sequential treatment for lamivudine interferonfi rst six months of lamivudine alone 100 mg/d. Then, starting from 7 months to 12 months, subcutaneously inject interferon5 million IU every two days. Control group of 98 people, to use lamivudine treatment, 100 mg/d over 12 months. Then follow up for 6 months. Test determination of liver,hepatitis b antigen and HBV-DNA in thefi rst 6 months, at the end of the experiment and at the end of the follow-up.Results The treatment of 6 months, the ALT into a normalnumber, e antigen into negative Numbers and HBV-DNA into negative number observation group and the control group are similar. The ALT into a normal number, e antigen into negative Numbers and HBV-DNA into negative number of the observation group are higher than the control group(P<0.05), after the follow-up,the rate of ALT rising again, e antigen again into the positive rate and the HBV-DNA again into positive rate lower than the control group(P<0.05).Conclusion The long-term curative effect of sequential therapyis better, and the bounce rate is low after the drug was stopped.%目的:比较拉米夫定干扰素序贯治疗与拉米夫定单药治疗HBeAg阳性慢性乙型肝炎患者的临床疗效。方法随机选取HbeAg阳性的慢性乙型肝炎患者198例,随机分为2组,观察组100例给予拉米夫定干扰素序贯治疗对照组98例给予单用拉米夫定治疗。2组分别于治疗6个月、实验结束时和随访结束时测定肝功能、乙肝抗原和HBV-DNA。结果治疗6个月时,观察组丙氨酸氨基转移酶(ALT)转为正常的例数、e抗原转为阴性的例数和HBV-DNA转为阴性的例数与对照组相比差异均无统计学意义。实验结束后观察组ALT转为正常的例数、e抗原转为阴性的例数和HBV-DNA转为阴性的例数均显著多于对照组,2组相比差异有统计学意义(P<0.05)。随访结束后,观察组ALT再次升高率、e抗原再次转为阳性率和HBV-DNA再次转为阳性率均显著低于对照组,2组相比差异有统计学意义(P<0.05)。结论拉米夫定单用治疗HBeAg阳性的慢性乙型肝炎在短疗程内有一定疗效,但长期应用疗效一般,且停药后容易出现反跳现象,而拉米夫定和干扰素序贯治疗长期疗效较好,且停药后反跳率较低,可以较好地弥补单用的不足,值得推广。
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