目的比较聚乙二醇干扰素a-2a单药及联合阿德福韦酯或联合恩替卡韦治疗慢性乙型肝炎的疗效及安全性。方法采用开放、随机、对照研究方法,将141例HBeAg阳性入选病例分为聚乙二醇干扰素a-2a组(A组,46例),聚乙二醇干扰素a-2a联合阿德福韦酯组(B组,46例)和聚乙二醇干扰素a-2a联合恩替卡韦组(C组,49例)。分别在治疗4、12、24和48周及随访24周时进行疗效和安全性评估。结果联合治疗组HBV DNA阴转率及下降幅度、HBeAg阴转率、ALT复常率均优于聚乙二醇干扰素a-2a单药治疗,2种联合治疗方案都具有较强的病毒抑制作用,且安全性好;联合恩替卡韦组病毒的下降幅度和表面抗原降低程度均大于联合阿德福韦酯组。结论聚乙二醇干扰素a-2a单药联合联合阿德福韦酯或联合恩替卡韦治疗HBeAg阳性乙型肝炎安全性好,疗效均优于聚乙二醇干扰素a-2a单药治疗,且聚乙二醇干扰素a-2a联合恩替卡韦疗效优于聚乙二醇干扰素a-2a联合阿德福韦酯。 Objective To compare the efficacy and safety of peginterferon alfa-2a and adefovir dipivoxil combined with entecavir in the treatment of chronic hepatitis B patients. Methods A total of 141 cases of HBeAg positive cases were divided into peginterferon alfa-2a group (group A, n = 46) and peginterferon alfa-2a combined with adefovir Weixi group (group B, n = 46) and peginterferon alfa-2a combined with entecavir (group C, n = 49). Efficacy and safety assessments were performed at 4, 12, 24 and 48 weeks of treatment and at 24 weeks of follow-up. Results In the combination therapy group, the negative rate of HBV DNA decline, the negative conversion rate of HBeAg and the normal ALT rate were better than those of peginterferon alfa-2a alone. Both combination regimens had strong viral suppression Role and good safety; combined entecavir group decreased the extent of reduction of the virus and surface antigens than the combined adefovir dipivoxil group. Conclusions Pegylated interferon alpha 2a combined with adefovir dipivoxil or combined with entecavir is safe and effective in the treatment of HBeAg-positive hepatitis B, and its efficacy is better than that of pegylated interferon alpha 2a alone Pegylated interferon alpha-2a combined with entecavir is superior to peginterferon alfa-2a in combination with adefovir dipivoxil.