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[目的]观察聚乙二醇干扰素初始联合核苷(酸)类似物治疗e抗原阳性慢性乙型肝炎(CHB)患者的疗效。[方法]对60例慢乙肝治疗患者进行研究,A组患者(n=29)使用聚乙二醇干扰素α-2a(Peg-IFNα-2a)联合阿德福韦酯治疗48周,B组患者(n=31)使用Peg-IFNα-2a联合阿德福韦酯及拉米夫定治疗48周。观察治疗过程中12、24、48周时患者ALT复常率、HBV-DNA应答率、HBeAg、HBsAg的转阴率和转换率。[结果]2组治疗结束时ALT复常率分别为82.8%(24/29)、83.9%(26/31),HBV-DNA应答率分别为86.2%(25/29)、90.3%(28/31),HBeAg血清学转换率分别为34.5%(10/29)、35.5%(11/31),HBsAg血清学转换率6.9%(2/29)、6.5%(2/31),差异无统计学意义(P>0.05)。[结论]Peg-IFNα-2a联合阿德福韦酯及拉米夫定治疗慢乙肝未显示疗效优势,初始全程Peg-IFNα-2a联合阿德福韦酯抗病毒治疗,可以提高病毒抑制的速度和血清学转换率。
[Objective] To observe the curative effect of peginterferon combined nucleoside (acid) analogues in patients with e antigen positive chronic hepatitis B (CHB). [Method] Sixty patients with chronic hepatitis B were studied. Patients in group A (n = 29) were treated with peginterferon alfa-2a (Peg-IFNα-2a) Patients (n = 31) were treated with Peg-IFNα-2a for 48 weeks with adefovir dipivoxil and lamivudine. ALT normalization rate, HBV-DNA response rate, HBeAg and HBsAg negative conversion rate and conversion rate were observed at 12, 24 and 48 weeks after treatment. [Results] The rates of abnormal ALT in the two groups were 82.8% (24/29) and 83.9% (26/31) respectively, and the rates of HBV DNA were 86.2% (25/29) and 90.3% (28 / 31), HBeAg seroconversion rates were 34.5% (10/29), 35.5% (11/31), HBsAg seroconversion rates 6.9% (2/29), 6.5% (2/31) Significance (P> 0.05). [Conclusion] The treatment of chronic hepatitis B with Peg-IFNα-2a combined with adefovir dipivoxil and lamivudine did not show the therapeutic effect. The initial full-course Peg-IFNα-2a combined with adefovir dipivoxil treatment could increase the rate of virus inhibition And seroconversion rate.