【摘要】 目的 探讨IFN-α抗病毒治疗慢性乙型肝炎(CHB)患者的效果，为CHB的抗病毒治疗提供参考。方法选取接受普通IFN-α治疗且资料完整的CHB患者118例，通过门诊定期复诊和电话随诊收集患者的乙肝五项[乙型肝炎表面抗原(HBsAg)、乙型肝炎表面抗体(HBsAb)、乙型肝炎e抗原(HBeAg)、乙型肝炎e抗体(HBeAb)、乙型肝炎核心抗体(HBcAb)]、乙肝DNA定量(HBV-DNA)和谷丙转氨酶(ALT)水平。比较治疗前后、随访期间不同时间点的HBV-DNA和HBsAg阴转率、HBeAg/HBeAb血清转换率和ALT复常率等。结果 HBV-DNA阴转率及HBsAg阴转率随治疗时间的延长而提高，HBV-DNA阴转率在治疗第24、36、48周时的阴转率明显高于第12周，HBsAg阴转率在治疗第48周明显高于第12周和24周，差异均有统计学意义(P<0.05)。停药后第24～432周各随访节点HBV-DNA阴转率及HBsAg阴转率呈先降后趋于稳定的趋势。HBeAg/HBeAb血清转换率随治疗时间的延长而升高，治疗第48周其转换率明显高于第12周(P<0.05);HBeAg/HBeAb血清转换率及SVR随停药时间的延长呈先降后趋于稳定的趋势。停药后，HBeAg/HBeAb血清转换率在各随访节点差异均无统计学意义(P>0.05)。病毒学复发率停药后先上升，在停药第144周呈现稳定趋势。ALT复常率在停药第144周呈现稳定趋势，停药第144周的ALT复常率明显高于停药第12周(P<0.05)。结论 IFN-α抗病毒治疗CHB可取得较好的疗效，在治疗及停药后各随访节点，HBV-DNA阴转率、HBsAg阴转率、ALT复常率、HBeAg/HBeAb转换率均可获得较高的应答率。更多还原

【Abstract】 Objective To investigate the efficacy of IFN-alpha antiviral therapy in patients with chronic hepatitis B(CHB) so as to provide a reference for CHB antiviral therapy in clinical practice.Methods 118 patients with CHB who were treated with regular IFN-α and had complete data were included in the study; the patients’ hepatitis B penta-scores [hepatitis B surface antigen(HBsAg),hepatitis B surface antibody(HBsAb),hepatitis B e antigen(HBeAg),hepatitis B e antibody(HBeAb),hepatitis B core antibody(HBcAb)],quantitative hepatitis B DNA(HBV-DNA) and alanine transaminase(ALT) levels were collected through regular outpatient follow-ups and telephone follow-ups.HBV-DNA and HBsAg negative conversion rates, HBeAg/HBeAb seroconversion rates, and ALT reversion rates were compared before and after treatment, and at different time points during the follow-up period.Results The HBV-DNA-negative rate and the HBsAg-negative rate increased with the duration of treatment: HBV-DNA-negative rate was significantly higher at the 24th, 36th, and 48th weeks after treatment than at the 12th week; HBsAg-negative rate was significantly higher at the 48th week than at the 12th and 24th weeks; the differences were statistically significant(P<0.05).A decreasing and then stabilizing tendency in the HBV-DNA-negative rate and the HBsAg-negative rate was observed at each follow-up node from week 24 to 432 after discontinuation.The HBeAg/HBeAb seroconversion rate increased with the duration of treatment and it was significantly higher at the 48th week than at the 12th week(P<0.05).A decreasing and then stabilizing tendency in the HBeAg/HBeAb seroconversion rate and the rate of sustained virological response was observed with the prolongation of discontinuation of the drug.After discontinuation, the differences in the HBeAg/HBeAb seroconversion rates were not statistically significant at each follow-up node(P>0.05).The virological relapse rate increased first after drug discontinuation and registered a stabilizing trend at the 144th week of drug discontinuation.The ALT relapse rate showed a stabilizing trend at the 144th week of drug discontinuation, and the ALT relapse rate at the 144th week of drug discontinuation was significantly higher than that at the 12th week of drug discontinuation(P<0.05).Conclusion IFN-α antiviral therapy for CHB can be of positive clinical efficacy, with relatively high response rates for HBV-DNA-negative rate, HBsAg-negative rate, ALT reversion rate, and HBeAg/HBeAb conversion rate at each follow-up node after treatment and discontinuation.更多还原