摘要
目的观察恩替卡韦联合聚乙二醇干扰素α-2a(PEG-IFNα-2a)治疗对HBeAg阳性慢性乙型肝炎患相关转阴率及肝组织病理的影响。方法选取我院收治的76例慢性乙肝患者为研究对象,随机分为观察组与对照组,各38例。对照组采用恩替卡韦治疗,观察组采用恩替卡韦联合PEG-IFNα-2a治疗,比较两组治疗后血清丙氨酸氨基转移酶(ALT)复常率、HBV DNA转阴率及HBeAg阴转率,并比较两组肝组织病理变化情况。结果治疗6个月后,两组ALT复常率、HBV DNA转阴率、HBeAg转阴率比较均无统计学意义(P>0.05);治疗12个月后,两组ALT复常率、HBV DNA转阴率比较仍无统计学意义(P>0.05);但观察组较对照组HBeAg转阴率明显升高,差异有统计学意义(P<0.05)。治疗后,观察组肝组织炎症活动度、纤维化程度较治疗前明显降低,且显著低于对照组(P<0.05)。结论恩替卡韦联合PEG-IFNα-2a治疗HBeAg阳性慢性乙肝对提高HBeAg阴转率效果显著,并且能降低肝炎症活动度及纤维化程度,效果优于单纯恩替卡韦治疗,值得推广应用。
Objective To observe the effect of entecavir combined with pegylated interferon α-2a （ PEG-IFN α-2a） treatment on related negative conversion rate and hepatic tissue pathology in patients with HBeAg positive chronic hepatitis B. Methods Seventy-six patients with chronic hepatitis B admitted to our hospital were randomly divided into observation group and control group ,with 38 cases in each group. Patients in the control group were treated with entecavir while patients in the observation group were treated with entecavir combined with PEG-IFN α-2a. The normalization rate of alanine aminotransferase （ALT） , negative conversion rates of HBV DNA and HBeAg and hepatic histopathological changes were compared between the two groups. Results 6 and 12 months after treatment, the normalization rate of ALT and negative conversion rates of HBV DNA and HBeAg showed no significant differences between the two groups （P 〉0. 05 ） but 12 months after treatment,the negative conversion rate of HBeAg in observation group was significantly higher than that in control group （P 〈 0. 05 ）. After treatment, the degree of inflammation and fibrosis of the liver tissue in the observation group decreased significantly and were significantly lower than those in the control group （P 〈 0. 05 ）. Conclusion The entecavir combined with PEG-IFN α-2a in the treatment of HBeAg-positive chronic hepatitis B can significantly improve the negative conversion rate of HBeAg, and can reduce the degree of liver inflammation and fibrosis with better effect than entecavir only. It is clinically worthy of promotion.
出处
《白求恩医学杂志》
2017年第3期295-297,共3页
Journal of Bethune Medical Science
