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目的观察聚乙二醇干扰素α-2a联合阿德福韦酯治疗HBe Ag阴性慢性乙型肝炎的效果。方法将HBe Ag阴性慢性乙型肝炎患者129例随机分为干扰素组、阿德福韦酯组以及联合治疗组各43例。比较3组ALT复常率、HBs Ag消除率和HBV DNA转阴率。结果 3组24周到48周ALT复常率均呈上升趋势,72周有所下降,但干扰素组、阿德福韦酯组72周时的ALT复常率均高于联合治疗组,尤以阿德福韦酯组最高,但差异无统计学意义(P>0.05);3组患者在HBs Ag清除率方面,自24周到72周呈上升趋势,干扰素组与阿德福韦酯组水平相当,差异无统计学意义(P>0.05),24、48、72周联合治疗组均明显高于其他2组,差异有统计学意义(P<0.05);在HBV DNA转阴率方面,3组均于48周达到峰值,于72周开始下降,24、48、72周联合治疗组均明显高于其他2组,差异均有统计学意义(P<0.05)。结论采取聚乙二醇干扰素α-2a联合阿德福韦酯对HBe Ag阴性慢性乙型肝炎进行治疗的临床效果显著,两者可产生协同作用,增强临床治疗效果,临床价值显著,值得关注并推广。
Objective To observe the effect of peginterferon alfa-2a combined with adefovir dipivoxil on HBeAg-negative chronic hepatitis B. Methods 129 patients with HBeAg-negative chronic hepatitis B were randomly divided into interferon group, adefovir dipivoxil group and combination therapy group, 43 cases each. The ALT normalization rate, HBsAg elimination rate and HBV DNA negative rate were compared between the three groups. Results The ALT normalization rate increased from 24 weeks to 48 weeks in 3 groups, and decreased in 72 weeks. However, the ALT normalization rates in interferon group and adefovir dipivoxil group were higher than those in combination group at 72 weeks Adefovir dipivoxil group was the highest, but the difference was not statistically significant (P> 0.05); The HBs Ag clearance rate of three groups increased from 24 weeks to 72 weeks, and the interferon group and adefovir dipivoxil group (P> 0.05). The combination of 24,48,72 weeks treatment group was significantly higher than the other two groups (P <0.05), and in the proportion of HBV DNA negative conversion rate (P <0.05) peaked at 48 weeks and began to decrease at 72 weeks. The combination of 24, 48 and 72 weeks was significantly higher than the other two groups (P <0.05). Conclusion The clinical effect of peginterferon alfa-2a and adefovir dipivoxil on HBeAg-negative chronic hepatitis B is remarkable, and the two can have synergistic effect and enhance the clinical curative effect, which is worth noting And promotion.