单磷酸阿糖腺苷联合乙肝疫苗治疗慢性乙型肝炎的临床研究

目的 :研究单磷酸阿糖腺苷 (Ara -AMP)联合乙肝疫苗治疗慢性乙型肝炎的疗效。方法 :6 0例慢性乙型肝炎患者 ,HBeAg 4 8例阳性 ,HBV -DNA均阳性。 6 0例随机分成两组 :Ara -AMP组 30例和干扰素 (IFN)组 30例。联合乙肝疫苗治疗 1个月、3个月、6个月后对肝功能和乙肝血清标志物进行检测分析。结果 :Ara -AMP联合乙肝疫苗治疗 1个月、3个月、6个月时 ,谷丙转氨酶 (ALT)复常率分别为 6 6 %、73%、80 % ;HBV -DNA转阴率分别为 16 6 %、36 7%、4 3 3%。HBeAg转阴率均为 5 2 % ;HBV -DNA转阴率治疗 3个月、6个月与治疗前比较有显著性差异 (P <0 0 1)。肝功能在治疗前后比较有显著差异 (P <0 0 5 )。干扰素联合乙肝疫苗治疗 1个月、3个月、6个月时 ,ALT复常率分别为 70 %、83%、90 % ;HBV -DNA转阴率均为 3 3% ,HBeAg转阴率分别为 7 1%、17 8%、17 8% ;肝功能在治疗前后比较有显著差异(P <0 0 5 ) ,HBeAg转阴率及HBV -DNA转阴率治疗前后比较均无显著差异。两组之间比较HBV -DNA转阴率有显著性差异 (P <0 0 1)。结论 :Ara -AMP联合乙肝疫苗治疗慢性乙型肝炎 ,疗程短 ,抗病毒疗效确切 ,停药的后续作用明显 ,改善肝功能显著 ,短期应用毒副作用小。

The Clinical Study of Ara - C Adenosine Monophosphate Combined with Hapatitis B Vaccine On Chronic Hepatitis B

Objective:To evaluate the efficacy of Ara-C adenosine monophophate(Ara-AMP) combined with hepatitis B vaccine in the therapy of chronic hepatitis B.Methods:60 cases of chronic hepatitis B were randomly divided into two groups:Ara-AMP group and IFN group 30 cases in Ara-AMP group were treated with Ara-AMP combined with hapatitis B vaccine,and 30 cases in IFN group with interferon(IFN) and hepatitis B vaccine.The liver function and hepatitis serum marker were detected after 1 month,3 and 6 months.Results:The recovery rate of alanine transaminase(ALT) after 1 month,3 and 6 months was respectively 66%,73% and 80% in Ara-AMP group,70%,83% and 90% in IFN group.There were signisicant difference in liver function before and after treatment in both groups(P<0.05).In Ara-AMP group,thenegative rate of hepatitis B virus deoxyribonucleic acid(HBV-DNA) after 1 month,3 and 6 months was respectively 16.6%,36.7% and 43.3%, there was significant difference before and aftere treatment on 3 and 6 months (P<0.01),the negative rate of hepatitis B e antigen(HBeAg) was 5.2%.In IFN group,the negative rate of HBV-DNA was 3.3%,that of HBeAg was respectively 7.1%,17.8% and 17.8%,there was no difference in that of HBeAg and HBV-DNA before and after treatment.There was significant difference in negative rate of HBV-DNA between two groups(P<0.05).Conclusion:The Ara-AMP combined with hepatitis B vaccine has a good effect on hepatitis B,with shorter course of treatment,less side effect and obvious follow-up effect after therapy.