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目的观察乙肝e抗原(HBe Ag)阳性慢性乙肝患者两种抗病毒方案的疗效及肾功能异常发生率比较。方法本次研究病例均来源于2012年2月—2014年4月三门峡市中心医院门诊部收治的78例HBe Ag阳性慢性乙肝患者,随机分为研究组和对照组,各39例,对照组实施普通干扰素α(IFN-α)治疗,研究组在对照组基础上另联合阿德福韦酯治疗,两组患者均持续给药1年。对两组治疗后抗病毒疗效(ALT复常率、HBV—DNA阴转率及HBe Ag阴转率)、肾功能异常发生率及药物不良反应进行观察比较。采用SPSS19.0统计软件进行统计分析,计量资料用均数±标准差(±s)表示,采用t检验,计数资料用率(%)表示,采用χ~2检验,P<0.05表示差异有统计学意义。结果治疗后研究组ALT复常率82.05%、HBV—DNA阴转率89.74%及HBe Ag阴转率87.18%分别均较对照组69.23%、71.79%和69.23%高,差异均有统计学意义(P<0.05);研究组治疗后肾功能异常发生率25.64%与对照组20.51%比较,差异无统计学意义(P>0.05);研究组药物不良反应总发生率53.85%和对照组43.59%比较,差异无统计学意义(P>0.05)。结论干扰素与阿德福韦酯联合抗病毒方案对HBe Ag阳性慢性乙肝患者抗病毒疗效更显著,联合药物方案具有更积极的临床作用。
Objective To observe the curative effect of two antiviral programs and the incidence of renal dysfunction in patients with chronic hepatitis B who are positive for hepatitis B e antigen (HBe Ag). Methods The study cases were all from 78 patients with HBeAg-positive chronic hepatitis B treated in Outpatient Department of Sanmen Central Hospital from February 2012 to April 2014. They were randomly divided into study group and control group, 39 cases in each group. The control group Normal interferon alpha (IFN-α) treatment, the study group in addition to the control group combined with adefovir dipivoxil treatment, two groups of patients were administered for 1 year. The anti-virus efficacy (ALT normalization rate, HBV-DNA negative conversion rate and HBeAg negative conversion rate), the incidence of renal dysfunction and adverse drug reactions were compared between the two groups after treatment. Statistical analysis was performed with SPSS19.0 statistical software. The measurement data were expressed as mean ± standard deviation (± s), t test was used and the data rate (%) was used as the count data. Chi-square test was used to test the difference Statistical significance. Results After treatment, the ALT normalization rate was 82.05%, the HBV-DNA negative conversion rate 89.74%, and the HBeAg negative conversion rate 87.18% were higher than the control group 69.23%, 71.79% and 69.23% respectively, the difference was statistically significant ( P <0.05). The incidence of renal dysfunction was 25.64% in the study group compared with 20.51% in the control group (P> 0.05). The total adverse drug reaction rate was 53.85% in the study group and 43.59% in the control group , The difference was not statistically significant (P> 0.05). Conclusions Interferon and adefovir dipivoxil combined with antiviral therapy is more effective in treating patients with HBeAg-positive chronic hepatitis B virus. The combination drug regimen has a more positive clinical effect.