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[目的]分析替比夫定序贯疗法在聚乙二醇干扰素α-2a(PEG-IFNα-2a)治疗48周后HBeAg未转阴的慢性乙型病毒性肝炎患者中的应用。[方法]选取我院PEG-IFNα-2a治疗48周后HBeAg未转阴的慢性乙型病毒性肝炎患者110例,分为对照组和治疗组,每组各55例。对照组经超过2个月的洗脱期后,通过替比夫定序贯疗法进行治疗,治疗组直接通过替比夫定序贯疗法治疗而非经洗脱期。对比2组经替比夫定序贯疗法治疗后的乙肝病毒DNA转阴率、磷酸肌酸水平、HBeAg转阴率和谷丙转氨酶复常率情况。[结果]2组患者治疗后的乙肝病毒DNA转阴率、磷酸肌酸水平和谷丙转氨酶复常率比较差异无统计学意义,而治疗后1、9、15个月治疗组HBeAg转阴率均明显高于对照组(P<0.05)。[结论]在PEG-IFNα-2a治疗48周后,相比经洗脱期后通过替比夫定序贯疗法治疗,直接通过替比夫定序贯疗法治疗而非经洗脱期更能够提高慢性乙型病毒性肝炎患者的HBeAg转阴率,且方法安全、有效、可行,应用价值更高。
[Objective] To analyze the application of telbivudine sequential therapy in patients with non-HBeAg-negative chronic hepatitis B after 48 weeks of peginterferon alfa-2a (PEG-IFNα-2a) treatment. [Methods] One hundred and ten patients with chronic hepatitis B who did not have HBeAg negative after 48 weeks of treatment with PEG-IFNα-2a in our hospital were divided into control group and treatment group, 55 cases in each group. The control group was treated with telbivudine sequential therapy after more than 2 months of elution and the treatment group was treated by telbivudine instead of elution. Comparison of two groups of telbivudine sequential therapy after treatment of hepatitis B virus DNA negative rate, creatine phosphrate, HBeAg negative rate and alanine aminotransferase normalization rate. [Results] There was no significant difference in DNA negative conversion rate, creatine phosphorate level and alanine aminotransferase normalization rate between the two groups after treatment, but the HBeAg negative rates in the treatment groups at 1, 9, and 15 months after treatment Were significantly higher than the control group (P <0.05). [Conclusions] After 48 weeks of treatment with PEG-IFNα-2a, telbivudine-treated patients were more likely to be treated than telbivudine by sequential therapy rather than by elution compared to after elution HBeAg negative rate in patients with chronic hepatitis B, and the method is safe, effective, feasible and more valuable.