【摘要】 目的　探讨α 干扰素和拉米夫定联合治疗慢性乙型肝炎的临床疗效及其影响因素。方法　将 5 8例慢性乙型肝炎患者随机分成治疗组和对照组的。治疗组同时使用α 干扰素及拉米夫定 6月 ,随后单用拉米夫定 6月 ;对照组单用拉米夫定 12月。结果　 (1)治疗组HBV DNA阴转率 71.4 % (2 0 / 2 8)与对照组 6 3.3% (19/ 30 )相比 ,无显著性差异 (P >0 .0 5 ) ;(2 )治疗组HBeAg/抗 HBe血清转换率 4 6 .2 % (13/ 2 8)明显高于对照组 2 0 % (6 / 30 ) (P <0 .0 5 ) ;(3)治疗组血清ALT及HBV DNA基线水平与病毒的完全应答率密切相关 (P <0 .0 5 ) ;(4 )在ALT >2×ULN及血清HBV DNA >1.0× 10 7拷贝 /ml的患者中 ,治疗组病毒的完全应答率明显高于对照组 (P <0 .0 5 )。结论　(1)α 干扰素联合拉米夫定治疗慢性乙型肝炎 ,HBV DNA阴转率与单用拉米夫定治疗无显著性差异 ,而HBeAg/抗 HBe血清转换率比单用拉米夫定治疗明显提高 ;(2 )对于ALT中度以上升高、HBV DNA高水平复制患者 ,α 干扰素与拉米夫定联合治疗短期疗效明显优于单用拉米夫定治疗更多还原

【Abstract】 Objective To evaluate the efficacy of interferon alpha combined with lamivudine in patients with chronic hepatitis B .Methods Fifty-eight patients were enrolled and randomized into two groups:28 received interferon alpha and lamivudine simultaneously for 6 months,then lamivudine alone for another 6 months; 30 patients received lamivudine alone for 12 months.Results (1)The rate of HBV-DNA turned to negative(71.4%,20/28)in combination group that was close to lamivudine alone group(63.3%,19/30)(P>0.05);(2)Proportion of HBeAg/Anti-HBe seroconversion in combination group(46.2%,13/28)was higher than lamivudine alone group(20%,6/30)(P<0.05);(3)The complete response rate of combination group was closely correlated with baseline ALT and HBV-DNA(P<0.05);(4)The complete response rate of combination group was significantly higher than lamivudine alone group in patients with serum ALT>2×ULN and HBV-DNA>1.0×10 7 copies/ml.Conclusion (1)The rate of HBV-DNA turned to negative in combination group was close to lamivudine alone group,but HBeAg/Anti-HBe seroconversion rate was higher in combination group;(2)The efficacy of combination therapy was better than lamivudine alone therapy in patients with at least moderately elevated baseline ALT and high level of HBV-DNA.更多还原