【摘要】 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。更多还原

【Abstract】 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-interferon alpha-2b.During the treatment,indicators such as blood routine,biochemistry 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 treatment is associated with the HBeAg serological conversion and HBV DNA negative rate at Week 48.After discontinuation,PEG-interferon alpha-2b keeps sustained response.更多还原