恩替卡韋聯(lián)合干擾素治療慢性乙型肝炎療效觀察

林治輝

[摘要] 目的 觀察恩替卡韋聯(lián)合干擾素治療慢性乙型肝炎的臨床療效。 方法 選擇2008年1月～2016年1月我院收治的輕中度慢性乙型肝炎患者106例，根據(jù)治療方法不同分為聯(lián)合組50例與對照組56例，兩組均予甘利欣、能量合劑、維生素、促肝細胞生長素等常規(guī)護肝治療，其中聯(lián)合組加用恩替卡韋聯(lián)合干擾素α-2b治療，比較兩組患者治療后的HBV-DNA轉(zhuǎn)陰率及HBeAg血清轉(zhuǎn)換率及兩組患者肝功能指標(biāo)AST、ALT及TBiL水平的變化。結(jié)果聯(lián)合組治療后的HBV-DNA轉(zhuǎn)陰率（80.00%）、HBeAg血清轉(zhuǎn)換率（30.00%）分別顯著高于對照組，組間比較差異具有顯著性（P<0.05）。兩組患者治療前的AST、ALT及TBiL水平組間比較無統(tǒng)計學(xué)差異（P>0.05）；治療后，兩組患者的AST、ALT及TBiL水平顯著降低（P<0.05）；且聯(lián)合組患者治療后AST、ALT及TBiL水平顯著低于對照組，組間比較差異具有顯著性（P<0.05）。 結(jié)論 恩替卡韋聯(lián)合干擾素治療慢性乙型肝炎療效確切，可以顯著改善肝功能，提高HBV-DNA轉(zhuǎn)陰率。

[關(guān)鍵詞] 慢性乙型肝炎；恩替卡韋；干擾素；肝功能

[中圖分類號] R512.62 [文獻標(biāo)識碼] B [文章編號] 1673-9701（2017）13-0108-03

[Abstract] Objective To observe the clinical efficacy of entecavir combined with interferon in the treatment of chronic hepatitis B. Methods 106 patients with mild to moderate chronic hepatitis B from January 2008 to January 2016 in our hospital were divided into combined group according to the different treatment methods，50 cases in the combined group and 56 cases in the control group， two groups were treated with Diammonium Glycyrrhizinate， energy mixture， vitamin， pHGF and other conventional liver protective treatment， the combined group was treated with entecavir combined with interferon treatment， after treatment， HBV-DNA negative rate and HBeAg seroconversion rates were compared between two groups，and the liver function indexes of AST， ALT and TBiL levels were compared between two groups. Results The HBV-DNA negative conversion rate（80.00%） and HBeAg seroconversion rate（30.00%） in the combined group were significantly higher than in the control group， and the difference was significant （P<0.05）. There was no statistical difference between AST， ALT and TBiL levels between two groups of patients before treatment（P>0.05）； after treatment， two groups of patients with AST， ALT and TBiL were significantly decreased（P<0.05）； and the AST， ALT and TBiL levels of joint group of patients after treatment were significantly lower than the control group， the difference was significant between two groups（P<0.05）. Conclusion Entecavir combined with interferon in the treatment of chronic hepatitis b curative has significant effect， can significantly improve the liver function， improve HBV-DNA negative rate.

[Key words] Chronic hepatitis B； Entecavir； Interferon； Liver function

慢性乙型肝炎（Chronic hepatitisB，CHB）為臨床上常見的傳染性疾病之一，由于乙肝病毒長期存在且不斷復(fù)制，可顯著增加肝癌及肝硬化的發(fā)病風(fēng)險，對患者的生命健康造成嚴重威脅[1]。目前臨床治療慢性乙型肝炎的常用藥物主要包括干擾素和核苷（酸）類藥物兩大類，即干擾素、拉米夫定、阿德福韋、替比夫定、恩替卡韋等，但其中任何一種藥物長期單獨使用均易發(fā)生病毒變異，產(chǎn)生耐藥[2]。恩替卡韋是一種的新型有效的核苷類抗病毒藥物，研究證實，其具有顯著的抗HBV病毒的作用，且耐藥率較低[3]，但關(guān)于恩替卡韋與干擾素聯(lián)合應(yīng)用治療慢性乙型肝炎的療效報道不多。2008年1月～2016年1月我院應(yīng)用恩替卡韋、干擾素聯(lián)合治療慢性乙型肝炎50例，現(xiàn)報道如下。

1 對象與方法

1.1 研究對……