【摘要】 目的比较干扰素α单用和联合拉米夫定治疗慢性乙型肝炎的临床疗效。方法86例慢性乙型肝炎患者随机分为三组。联合组 32例 ,给予干扰素α 1b 5MU ,肌肉注射 ,每周 3次 ,共 2 4周 ,拉米夫定 1 0 0mg口服 ,每日 1次 ,共 4 8周 ;干扰素组 30例 ,拉米夫定组 2 4例。观察 3组HBeAg阴转率、HBV DNA阴转率、HBeAg转换率及谷丙转氨酶 (ALT)复常率。结果3组病人ALT复常率、HBeAg血清转换率无明显差异 ,HBeAg阴转率联合组明显高于拉米夫定组 (P <0 .0 5 ) ,HBeAg复发率三组差异无显著性 (P >0 .0 5 )。治疗结束时 ,HBV DNA阴转率联合组及拉米夫定组明显高于干扰素组 (P <0 .0 5 )。随访 2 4周 ,HBV DNA复发率 ,拉米夫定组明显高于干扰素组及联合组 ,联合组ALT的反跳率明显低于干扰素组及拉米夫定组 ,差异有显著性意义 (P <0 .0 5 )。结论干扰素α或拉米定治疗慢性乙型肝炎疗效较好 ,联合用药抑制ALT反跳优于单用干扰素或拉米夫定更多还原

【Abstract】 ObjectivesTo compare the therapeutic efficacy of Interferon a (IFN α) alone and its combination with lamivudine in treatment of chronic hepatitis B (CHB). MethodsEighty six patients with CHB were randomly divided into 3 groups:①Group A, combined therapy was used in 32 patients. 5 MU of IFNα 1b was given im for 24 wks, 3 times per wk.; while oral administration of 100mg lamivudine was scheduled daily for 48 wks.; ②Group B,IFN a was injected im alone in 30 patients; ③Group C, oral lamivudine was taken alone in 24 patients.The negative changing rates of serum HbeAg and HBV DNA, the serum turnover rate of HbeAg and normalization rate of serum alanine aminotransferase (ALT) activity in 3 groups were observed and analyzed.ResultsALT normalization rate and negative changing rate of serum HBeAg showed no significant variation among all three groups (P>0.05), but negative changing rate of serum HBeAg in combined therapy group was significantly higher than that in lamivudine group (P<0.05). At the end of treatment, negative changing rates of serum HBV DNA in combined therapy group and lamivudine group were distinctly higher than those in INF αgroup (P<0.05). After follow up for 24 wks, HBV DNA relapse rate in lamivudine group was obviously higher than that in groups A and B ; whereas the rebounding rate of serum ALT activity in combined therapy group was clearly lower than those in groups B and C.ConclusionThe INF αor lamivudine is efficient in the treatment of patients with CHB. To inhibit the rebounding rate of serum ALT activity , INF αcombined with lamivudine is superior to INF α or lamivudine alone .更多还原