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目的 为了解不同剂量和疗程干扰素对慢性乙型肝炎的疗效。方法 应用α -2b干扰素治疗慢性乙型肝炎 ,89例患者随机分为A组 ( 3mu ,3个月 ,n =3 7)、B组 ( 3mu ,6个月 ,n =2 8)、C组 ( 5mu ,3个月 ,n =15 ) ,D组 ( 5mu ,6个月 ,n =9)。另设E组 69例为对照组 ,不用干扰素。治疗前全部病例ALT升高超过正常值上限两倍以上 ,且均为HBsAg ,HBeAg ,HBV -DNA阳性。结果 疗程结束时A～E各组的ALT复常率分别为 5 4% ,65 % ,73 % ,78% ,64 % ;HBsAg阴转率为 8% ,9% ,13 % ,11% ,2 % ;HBeAg阴转率为 43 % ,5 6% ,60 % ,78% ,12 % ;HBV -DNA阴转率为 43 % ,61% ,67% ,78% ,13 %。结论 α -2b干扰素具有较好的抗乙肝病毒作用 ,随访 2a显示CAH疗效优于CPH ,且与大剂量和长疗程有关。血清HBeAg和HBV -DNA的清除可改善患者临床预后。
Objective To understand the different doses and duration of interferon treatment of chronic hepatitis B. Methods α - 2b interferon was used to treat chronic hepatitis B. Eighty - nine patients were randomly divided into group A (3mu, 3 months, n = 37), group B (3mu, 6 months, n = 28), C Group (5mu, 3 months, n = 15), Group D (5mu, 6 months, n = 9). Another set E group 69 cases as control group, without interferon. ALT in all cases before treatment rose more than twice the upper limit of normal, and were HBsAg, HBeAg, HBV DNA positive. Results At the end of the course of treatment, ALT normalization rates were 54%, 65%, 73%, 78% and 64%, respectively; the negative conversion rates of HBsAg were 8%, 9%, 13% and 11% %. The negative conversion rates of HBeAg were 43%, 56%, 60%, 78% and 12%, respectively. The HBV DNA negative conversion rates were 43%, 61%, 67%, 78% and 13%, respectively. Conclusion α -2b interferon has a good anti-hepatitis B virus effect, follow-up 2a showed better efficacy of CAH than CPH, and high-dose and long-course. Clearance of serum HBeAg and HBV-DNA may improve the patient’s clinical prognosis.