拉米夫定联合干扰素治疗慢性乙型肝炎的临床观察

目的评价拉米夫定(LMD)联合干扰素(INF)治疗慢性乙型肝炎(CHB)的疗效和安全性,探讨二者联合治疗的协同作用。方法将185例HBV-DNA和HBeAg阳性的CHB患者随机分为A、B、C三组:A组采用LMD与INF联合治疗,B组单用LMD治疗,C组单用INF治疗。A、B两组LMD均为100mg/d,口服,12个月为1疗程,但A组于LMD治疗第7个月开始加用INF 3MU,3次/周,6个月为1疗程;C组单用INF 3MU,3次/周,6个月为1疗程。三组均在1疗程结束时进行疗效评价,治疗结束后随访12个月。结果疗程结束时,A、B两组ALT复常率、HBV-DNA阴转率差异无统计显著性(P>0.05),A组HBeAg阴转率、HBeAg/抗-Hbe血清转换率均显著高于B组,差异有统计显著性(P<0.05);A、C两组比较,A组以上四项指标均显著高于C组,差异有统计显著性(P<0.05)或高度统计显著性(P<0.01)。随访结束时,A组以上指标均显著高于B、C组,差异有统计显著性(P<0.05)或高度统计显著性(P<0.01)。结论LMD联合INF治疗CHB疗效明显优于单用LMD或INF,是CHB患者安全而较有效的治疗方法。

Clinical Observation on Lamivudine Combined with Interferon Treating Chronic Hepatitis B

Objective To evaluate the efficacy and safety of lamivudine(LMD) combined with interferon(INF) on chronic hepatitis B(CHB) and to discuss the cooperating effect of LMD and INF combination therapy.Method One hundred and eighty-five CHB patients with positive HBV-DNA and HBeAg were randomly divided into three groups.Group A,B and C were treated with LMD and IFN combination,LMD or IFN alone respectively.The patients in both groups A and B received LMD 100 mg/d orally,12 months as a course.But the patients in group A received IFN 3MU from the 7th month,three times weekly,6 months as a course.The patients in group C received IFN 3MU,three times weekly,6 months as a course.The effects were evaluated at the end of a course.All patients were followed up for 12 months after finishing the treatment.Results When a course had been taken,there were no significant statistical differences both in the normalization rate of ALT and the lose rate of serum HBV-DNA between group A and group B(P>0.05).The lose rate of HBeAg and seroconversion rate of HBeAg/anti-HBe in group A were significantly higher than those in group B(P<0.05).The four indexes in group A were significantly higher than those in group C(P<0.05 or <0.01).At the end of follow up,the indexes in group A were significantly higher than those in both group B and C(P<0.05 or <0.01).Conclusions LMD and IFN combination therapy is effective and safe for CHB patients.Its efficacy is superior to LMD or IFN only.