聚乙二醇干扰素α加用阿德福韦酯治疗HBeAg阳性慢性乙型肝炎的效果观察

游佳; 陈靖; 叶巧霞; 郑琦; 朱月永; 董菁; 刘豫瑞; 江家骥

doi:10.3969/j.issn.1001-5256.2016.04.015

聚乙二醇干扰素α加用阿德福韦酯治疗HBeAg阳性慢性乙型肝炎的效果观察

DOI: 10.3969/j.issn.1001-5256.2016.04.015

1. 福建医科大学附属第一医院肝病中心
2. 福建医科大学

基金项目:

福建省卫生厅青年课题立项单位资助项目(2012-2-48)；

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中图分类号: R512.62
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- 出版日期: 2016-04-20

Efficacy of add- on adefovir dipivoxil at week 12 /24 in HBe Ag- positive chronic hepatitis B patients during PEG-IFNα therapy

Liver Diseases Research Center, The First Affiliated Hospital of Fujian Medical University

Research funding:

摘要

摘要:
目的评价聚乙二醇干扰素（PEG-IFN）α治疗HBe Ag阳性慢性乙型肝炎（CHB）患者12/24周联合阿德福韦酯（ADV）的疗效。方法回顾性收集2009年10月-2014年1月在福建医科大学附属第一医院接受PEG-IFNα治疗12周,HBV DNA≥105拷贝/ml的HBe Ag阳性CHB患者。根据治疗方案分为12周联合ADV组（A组,n=36）、24周联合ADV组（B组,n=19）及PEGIFNα单药治疗组（C组,n=19）,比较治疗48周联合应答率,并分析影响疗效的因素。多组间比较采用单因素方差分析,计数资料比较采用χ2检验,疗效预测采用受试者工作特征曲线和Cox多因素回归分析。结果治疗48周时,A组的联合应答率为27.78%（10/36）,高于B组5.26%（1/19）和C组5.26%（1/19）（P值均为0.045）;12周的HBe Ag下降值、24周HBe Ag下降值和24周HBV DNA下降值预测联合应答的阴性预测值分别为90.0%、94.44%和94.55%。24周HBV DNA水平<103拷贝/ml和24周HBe Ag...
- 肝炎,乙型,慢性 /
- 聚乙烯二醇类 /
- 干扰素α /
- 阿德福韦酯
Abstract:
Objective To investigate the efficacy of add- on adefovir dipivoxil( ADV) at week 12 /24 in HBe Ag- positive chronic hepatitis B( CHB) patients with hepatitis B virus( HBV) DNA levels of ≥105copies / ml during pegylated interferonα( PEG- IFNα) therapy.Methods A retrospective analysis was performed on 74 HBe Ag- positive CHB patients,who had HBV DNA levels of ≥105copies / ml after12 weeks of PEG- IFNα treatment in The First Affiliated Hospital of Fujian Medical University from October 2009 to January 2014. These patients were divided into group A( n = 36),which was given ADV at week 12 of PEG- IFNα treatment,group B( n = 19),which was given ADV at week 24 of PEG- IFNα treatment,and group C( n = 19),which was not given ADV during the PEG- IFNα treatment. The combined response rate after 48 weeks of treatment was compared between the three groups,and the influencing factors for treatment outcome were investigated. Comparison of continuous data( mean ± SD) between the three groups was made by one- way analysis of variance,and comparison of categorical data was made by chi- square test. The receiver operating characteristic curve and multivariate Cox logistic analysis were used to evaluate the predictive values of these parameters. Results After 48 weeks of treatment,the combined response rate of group A( 27. 78%,10 /36) was significantly higher than those of group B( 5. 26%,1 /19) and group C( 5. 26%,1 /19)( both P =0. 045). The negative predictive values of HBe Ag decrease at week 12,HBe Ag decrease at week 24,and HBV DNA decrease at week 24 for combined response were 90. 0%,94. 44%,and 94. 55%,respectively. HBV DNA level at week 24 < 103 copies / ml and HBe Ag decrease at week 24 > 1. 06 log10 S / CO were independent predictive factors for combined response. Conclusion Add- on ADV therapy could increase the 48- week combined response rate of HBe Ag- positive CHB patients who have HBV DNA levels of ≥105copies / ml after 12 weeks of PEG- IFNα treatment. The HBV DNA and HBe Ag decreases at week 24 have high negative predictive values for combined response.
- hepatitis B,chronic /
- polyethylene glycols /
- interferon-alpha /
- adefovir dipivoxil

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参考文献(10)

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