拉米夫定联合干扰素α治疗慢性乙型肝炎疗效观察

目的研究拉米夫定联合干扰素α对慢性乙型肝炎病人的疗效。方法对1999~2001年深圳市东湖医院慢性乙型肝炎病人87例,随机分为2组,观察组36例,用拉米夫定(100mg/d)联合干扰素α(每次5mU)隔日1次肌注,26周后单用拉米夫啶至104周。对照组51例,单用拉米夫啶100mg/d,疗程104周,并评估疗效。结果两组HBVDNA转阴率差异无显著性(P=0.24),联合治疗组的HBeAg/抗-HBe血清转换率高于拉米夫定组(38.9%对17.6%,P=0.03)。联合治疗组的HBVYMDD变异率较低(22.2%对43.1%,P=0.04)。结论联合治疗的2年疗效优于单用拉米夫定,且能减少病毒YMDD变异。

Long-term effect of lamivudine combined with interferon alpha treatment for chronic hepatitis B virus infection

Objective To evaluate the efficacy of 2-year treatment of interferon alpha combined with lamivudine therapy in chronic hepatitis B patients. Methods From 1999 to 2001 87 patients were enrolled and randomized into two groups.36 patients received interferon alpha and lamivudine simultaneously for 26 weeks,then lamivudine alone for 76 weeks.51 patients received lamivudine alone for 104 weeks.The efficacy was evaluated by biochemical and virological parameters.The YMDD motif was detected in both groups. Results There was no difference between two groups in HBV DNA response ( P =0.24).Proportion of HBeAg/Anti-HBe seroconversion in combination group was significantly higher than lamivudine group (38.9% vs 17.6%)( P =0.03).HBV YMDD mutation rate in combination group was lower than in lamivudine group (22.2% vs 43.1%, P =0.04). Conclusion The efficacy of combination therapy appeares to be better than lamivudine monotherapy.Combination treatment may delay or diminish the development of HBV YMDD mutation.