聚乙二醇干扰素α-2a联合恩替卡韦治疗HBeAg阳性慢性乙型肝炎的临床研究

摘要

目的：观察聚乙二醇干扰素α‐2a（Peg‐IFNα‐2a）联合恩替卡韦（ETV）延长疗程至96周治疗HBeAg阳性慢性乙型肝炎（CHB），随访24周的疗效。方法：165例HBeAg阳性CHB患者分为2组：A组67例，Peg‐IFNα‐2a联合ETV治疗；B组98例，ETV 治疗。疗程96周。在治疗的12、24、48、72、96周及随访24周时检查 ALT、HBV DNA、HBeAg、HBsAg。结果：两组患者HBeAg血清学转换率比较：在治疗的48、72、96周及随访24周时，P均＜0．01，差异有统计学意义；HBsAg血清学转换率比较：在治疗的48周，P＜0．05，在72、96及随诊24周，P均＜0．01，差异有统计学意义。结论：Peg‐IFNα‐2a联合ETV并延长疗程可提高HBeAg阳性CHB患者HBeAg及HBsAg血清学转换率。%Objective:To investigate the efficacy of a 96‐week course of Peg‐IFNα‐2a and entecavir(ETV)combination therapy for achieving seroconvesion at 24 weeks after completion in patients with chronic hepatitis B(CHB) .Methods:A total of 165 CHB patients with positivity for hepatitis B e antigen(HBeAg) were randomly divided into two groups (A , B) .67 patients in group A were treated with Peg‐IFNα‐2a and ETV .89 patients in group B were treated with ETV .All patients were treated for rates of conversion to HBV DNA negative status ,alanine aminotransferase (ALT) normaliza‐tion ,HBeAg and HBsAg seroconversion .Results:The rates of HBeAg serconversion were significantly different be‐tween the two groups at treatment weeks 48 ,72 and 96 ,at 24 weeks after treatment completion ,all P<0 .01 .The rates of HBsAg serconversion were significantly different between the two groups at 48 weeks (P<0 .05) ,the rates of HB‐sAg serconversion were significantly different between the two groups at treatment weeks 72 and 96 ,at 24 weeks after treatment completion ,all P<0 .01 .Conclusion:Prolonged Peg‐IFNα‐2a plus ETV combination therapy can significantly improve the rates of HBeAg and HBsAg seroconversion in HBeAg positive CHB patients .