拉米夫定联合干扰素治疗慢性乙型病毒性肝炎的疗效观察

目的：探讨拉米夫定联合干扰素治疗慢性乙型病毒性肝炎的临床疗效，为患者停药提供科学的临床依据。方法：选取2010年1月．2011年1月在我院肝病门诊就诊的确诊为乙型病毒性肝炎的患者100例，与患者沟通后，将患者按照就诊意愿，分为联合使用干扰素和拉米夫定的治疗组以及单纯使用拉米夫定的对照组，2组各50例，疗程均为1年。观察治疗后24、48周患者丙氨酸转氨酶（ALT）恢复结果、乙型肝炎病毒表面抗原（HBeAg）以及乙型肝炎病毒脱氧核糖核酸（HBV—DNA）转阴结果、不良反应发生率以及耐药率、治疗费用。结果：拉米夫定和干扰素联合治疗24周，患者ALT恢复率为96％（48／50），高于对照纽的68％（34／50），2组差异具有统计学意义（P〈0．05）；拉米夫定和干扰素联合治疗24、48周，患者HBeAg转阴率分别为66％（33／50）、64％（32／50），对照组分别为8％（4／50）、12％（6／50），2组比较，差异有统计学意义（P〈0．05）；拉米夫定和干扰素联合治疗48周，患者HBV-DNA转阴率为96％（48／50），高于对照组的72％（36／50），2组差异具有统计学意义（P〈0．05）。治疗组患者耐药率为44％（20／50），治疗成本为5712元，均明显低于对照组的76％（38／50）和11328元，2组差异均具有统计学意义（P〈O．05）。结论：拉米夫定联合干扰素治疗慢性乙型病毒性肝炎的效果优于单独应用拉米夫定，临床上采用该治疗方法，可以有效地指导患者门诊停药。

Clinical Efficacy of Lamivudine Plus Interferon for Chronic Hepatitis B

OBJECTIVE ：To explore the clinical efficacy of lamivudine plus interferon for chronic hepatitis B so as to provide scientific basis for patients＇ drug discontinuance. METHODS： A total of 100 patients who have been confirmed as having chronic hepatitis B during Jan. 2010-Jan. 2011 during outpatient visit of liver clinic of our hospital were assigned to receive either interferon plus lamivudine （treatment group ） or lamivudine alone （control group） for 1 year of 50 cases each after gaining consent from patients. After treatment of 24 and 48 weeks, the alanine aminotransferase （ALT） recovery, negative-conversion rates of hepatitis B virus surface antigen （HBeAg） and hepatitis B virus DNA （HBV-DNA） , the incidence of adverse reactions and the rate of drug resistance as well as the cost of treatment were recorded. RESULTS： After treatment with lamivudine plus interferon for 24 weeks, the ALT recovery rate was 96% （48/50）, which was higher than 68% （34/50） in the control group, with statistically significant differences noted between two groups （ P 〈 0.05 ）. After treatment with lamivudine plus interferon for 24 and 48 weeks, the negative-conversion rates of HBeAg was 66% （33/50）, 64% （32/50）, respectively, as compared with 8% （4/50） and 12% （6/50）, respectively in the control group, and the differences were statistically significant （ P 〈 0.05 ）. After treatment with lamivudine plus interferon for 48 weeks, the negative-conversion rate of HBV-DNA was 96% （48/50）, which was higher than 72% （36/50） in the control group, showing statistically significant differences between two groups （ P 〈 0. 05 ）. The drug resistant rate and treatment cost in the treatment group were significantly lower than in the control group [44% （20/50） vs. 76% （38/50） and 5 712 Yuan vs. 11 328 Yuan], with statistically significant differences noted between two groups （P 〈 0. 05 ）. CONCLUSION： Treatment of chronic hepatitis B with lamivudine plus interferon resulted in better efficacy than did lamivudine alone. Applying the above-mentioned therapy clinically serves as effectively guidance in outpatients＇ drug discontinuance.