干扰素-α联合叶下珠胶囊治疗慢性乙型肝炎疗效观察

目的探讨干扰素-α联合叶下珠胶囊治疗慢性乙型肝炎的临床疗效。方法选择慢性乙型肝炎患者56例随机分为两组，治疗组为干扰素-α与叶下珠胶囊联合治疗，对照组为单用干扰索-α。结果治疗组治疗后3个月和6个月ALT复常率分别为89．3％和96．4％，而对照组则分别为67．9％和78．6％；治疗组HBeAg阴转率分别为57．1％和67．9％，而对照组则分别为28．6％和39．3％；治疗组HBVDNA阴转率分别为64．3％和71．4％，而对照组则分别为35．7％和42．9％（P〈0．05）。结论干扰素-α联合叶下珠胶囊治疗慢性乙型肝炎，可促进患者肝功能改善，增强抗HBV作用。     

α-1 b干扰素治疗慢性乙型肝炎疗效分析

目的评价不同剂量的α-1b干扰素治疗慢性乙型肝炎(CHB)的疗效。方法将48例CHB患者随机分为A、B两组,分别采用α-1b干扰素3MU和5MU治疗,疗程均为6个月。结果在治疗结束时,A、B两组ALT复常率及HBVDNA、HBeAg和HBsAg阴转率分别为42.3%对45.5%、46.2%对54.5%、34.6%对40.9%和7.7%对13·6%;在随访6月时则分别为46.2%对40.9%、46.2%对50%、34.6%对40.9%和7.7%对13.6%,各率差异均无显著性(P>0.05)。B组一般性毒副反应发生率(90.9%)高于A组(65.4%,P<0.05)。结论α-1b干扰素3MU和5MU治疗CHB在疗效方面大致相同。     

拉米夫定联合干扰素α-2b治疗慢性乙型肝炎疗效观察

目的比较拉米夫定联合干扰素α-2b与单用拉米夫定治疗慢性乙型肝炎的疗效。方法26例慢性乙型肝炎患者接受拉米夫定联合干扰素α-2b联合治疗1.5年;34例单用拉米夫定1.5年。结果治疗结束时,联合组HBeAg/抗HBe转换率为65.4%,优于单用组的37.6%(P<0.001);两组HBV DNA转阴率分别是96.2%、94.1%(P>0.05);联合组完全应答率38.5%,优于单用组17.6%(p<0.01)。单用拉米夫定组3例出现YMDD变异。联合治疗组出现1例HBsAg转阴。结论拉米夫定与干扰素α-2b联合治疗慢性乙型肝炎,可提高HBeAg/抗Hbe血清转换率及综合应答率,并可防止或减少YMDD变异的发生。     

干扰素联合小柴胡汤治疗慢性乙型肝炎50例疗效观察

我们应用国产α-2b干扰素联合中药小柴胡汤治疗慢性乙型肝炎（CHB）50例，取得较好疗效。现报告如下。     

大剂量干扰素α-2b治疗HBeAg阳性慢性乙型肝炎疗效观察

目的观察大剂量干扰素α-2b治疗慢性乙型肝炎的临床疗效。方法治疗组72例慢性乙型肝炎患者应用干扰素α-2b 6MU治疗6个月,对照组55例慢性乙型肝炎患者应用干扰素α-2b 3MU治疗6个月,比较治疗结束时和随访6个月时的疗效。结果大剂量干扰素治疗组患者在治疗结束和随访6个月时,HBeAg阴转、HBV DNV阴转和ALT复常率分别为41.7%、83.3%、86.1%和43.1%、79.2%和80.6%,而小剂量组则分别为29.1%、54.5%、49.1%（P〈0.05）和27.3%、47.3%、47.3%（P〈0.05）;在随访6个月时,两组综合疗效的比较,CR（41.7%对25.5%）和NR（9.7%对34.6%）均有显著性差异（P〈0.05）;在大剂量治疗组患者中,流感样症状（97.2%）、ALT明显升高（27.8%）和白细胞减少（91.7%）发生率明显高于小剂量治疗组（分别为87.3%、3.6%和54.5%。结论大剂量干扰素α-2b治疗慢性乙型肝炎患者,疗效更好。     

α-干扰素联合乙肝疫苗及叶下珠治疗慢性乙型肝炎48例疗效观察

目的观察干扰素联合乙肝疫苗和叶下珠治疗慢性乙型肝炎的疗效。方法应用α-干扰素联合乙肝疫苗和叶下珠胶囊治疗6个月。结果治疗3个月时HBVDNA转阴19例(39·7%),水平下降20例(41·6%),无效9例(18·6%)。6个月时HBVDNA转阴38例(75%),水平下降3例(6·2%),无效7例(16·6%);3个月时HBeAg转阴18例(37·5%),6个月时HBeAg转阴30例(62·5%)。结论α-干扰素联合乙肝疫苗和叶下珠治疗慢性乙型肝炎可提高HBVDNA及HBeAg阴转率。     

聚乙二醇干扰素α-2a与干扰素α-2b治疗慢性乙型肝炎的临床疗效对比分析

本组应用聚乙二醇干扰素α-2a(PEG-IFN-α2a)治疗慢性乙型肝炎20例,与单用普通干扰素α2b例进行疗效对比,现将结果报道如下:1资料和方法1·1病例选择:诊断符合2000年修订的《病毒性肝炎防治方案》选择慢性乙型肝炎40例,分为二组:聚乙二醇干扰素α-2a 20例,其平均年龄为41·5±1     

干扰素α-2b治疗HBeAg阳性慢性乙型肝炎的疗效及预测

目的观察十扰素α-2b治疗HBeAg阳性慢性乙型肝炎的疗效及应答预测因素。方法采用多中心临床试验,共53例患者,年龄（27．5±9．1）岁,男44例（83．0％）,隔日1次干扰素α-2b5MU,共24周,停药后随访24周。结果治疗前ALT131．0（99．0,192．8）U／L,AST78．5（55．8,1223）U/L,TBIL13．3（9．8,17．8）μmol／L,HBVDNA（8．0±0．9）log10 copies／ml。治疗后1d HBVDNA下降为（7．0±1．0）log10 copies／ml（P〈0．01）,15例（33．3％）下降超过2．0log10 copies／ml。治疗结束和随访结束时HBVDNA分别为（4．9±1．5）log10 copies／ml和（5：3±1．6）log10 copies／ml,HBeAg阴转率分别为16．0％（8／50）和20．0％（8／40）,HBeAg血清转换率分别为14．0％（7／50）和20．0％（8／40）,完全应答率分别为4．2％（2／48）和7．9％（3／38）,部分应答率分别为35．4％（17／48）和34．2％（13／38）。治疗结束时完全应答[3.3（2．0,4．5）log10 copies／ml]和部分应答[3．0（1．4,4．1）log10 copies／ml]者在12周时HBVDNA水平较基线下降值高于无应答者[1．2（0．7,1．7）log。。copies／ml（P〈0．05）]。病程和基线HBVDNA水平影响治疗结束综合应答;基线ALT和HBVDNA水平影响随访结束综合应答。结论干扰素α-2b能快速降低HBeAg阳性慢性乙型肝炎患者的病毒载量,早期HBVDNA水平对综合应答有预测作用,基线HBVDNA水平影响治疗结束和随访结束时综合应答。     

干扰素α-2b联合拉米夫定治疗慢性乙型肝炎疗效观察

目的 观察干扰素联合拉米夫定治疗慢性乙型肝炎患者的疗效.方法 90例慢性乙型肝炎患者随机分为两组:42例干扰素α-2b联合拉米夫定治疗组,48例单用拉米夫定对照组:观察比较两组患者治疗后HBVDNA水平,乙型肝炎病毒血清标志物及肝功能变化.结果 治疗结束时,联合治疗组患者血清中HBVDNA阴性率和肝功能复常率明显高于单用拉米夫定治疗组,联合治疗组完全应答率40.5%,优于单用拉米夫定治疗组22.9%(P＜0.01);随访24周联合治疗组的上述指标仍高于拉米夫定对照组(P＜0.05).结论 干扰素α-2b联合拉米夫定治疗慢性乙型肝炎,可提高HBeAg/抗HBe血清转换率及综合应答率,并可防止或减少YMDD变异的发生.     

干扰素-α2b联合苦参素胶囊治疗慢性乙型肝炎40例疗效观察

目的观察干扰素-α2b联合苦参素胶囊治疗慢性乙型肝炎的疗效。方法随机选取78例慢性乙性肝炎患者,40例患者给予干扰素-α2b和苦参素胶囊治疗6个月,另38例患者接受一般护肝治疗。结果在治疗结束时,抗病毒组患者ALT复常率为92.5%,HBeAg转阴率为55%,HBVDNA阴转率62.5%,均明显高于对照组。结论干扰素-α2b与苦参素联合治疗慢性乙型肝炎疗效显著。     

用血清病毒DNA定量观察干扰素对慢性乙型肝炎病毒感染者的疗效

目的通过测定HBeAg阳性慢性肝炎(CHB)血清HBV-DNA水平,判断干扰素在病情治疗中的作用.方法28例HBeAg阳性CHB接受干扰素治疗.血清HBV-DNA浓度测定应用AG-9600 Amplisensor荧光PCR定量系统,测定范围定为103.00-9.50 copies/mL.结果 28例HBeAg阳性CHB患者治疗结束时呈完全应答(CR)者13例,无应答(NR)15例.对13例CR患者继续随访6个月,其中4例血清ALT再升高(复燃).血清HBV-DNA水平在治疗前,CR不伴ALT复燃组、CR伴ALT复燃组和NR组之间无差异;治疗结束时,CR不伴ALT复燃组HBV-DNA为103.44±0.43 copies/mL,明显低于CR伴ALT复燃组(106.84±0.51 copies/mL)和NR组(107.18±0.66 copies/mL).结论在HBeAg阳性CHB病例,干扰素治疗结束时,检测HBV-DNA水平对于判断疗效有指导价值,HBV-DNA低于104 copies/mL往往能取得持久疗效.     

干扰素治疗前后慢性乙型肝炎患者的血清学和组织学观察

目的　探讨干扰素治疗前后 ,慢性乙型肝炎患者的血清学和肝组织学变化。方法　于干扰素治疗前 1周内和治疗后 1周内 ,取 2 4例慢性乙型肝炎患者的血清和肝脏活检组织 ,检测其血清ALT、HBsAg、HBcAg、HBeAg、HBVDNA和金属蛋白酶组织抑制剂 1(TIMP 1) ,评价肝组织学活动指数 ,检测肝脏中的HBsAg、HBcAg、HBeAg、活化的肝脏星状细胞 (HSC)和TIMP 1。 结果　治疗后 ,9/ 2 4 (37.5 % )的患者发生了应答反应。与治疗前相比 ,干扰素治疗后慢性乙型肝炎患者血清中的HBVDNA明显下降 (P <0 .0 5 ) ,血清中的TIMP 1、肝脏的组织学活动指数 (HAI)、HBcAg、HBeAg、活化的HSC和TIMP 1均有明显下降 (P <0 .0 5 )。结论　干扰素治疗慢性乙型肝炎患者 ,可以抑制病毒复制 ,减少肝组织中病毒抗原表达 ,减少血清和肝组织中的TIMP 1,减少肝脏中活化的HSC数量。     

慢性乙型肝炎拉米夫定耐药患者HBV基因型及ALT变化的观察

观察慢性乙型肝炎患者用拉米夫定治疗后HBVP基因变异与不同HBV基因型感染及HBV DNA复升水平和转氨酶变化.收集51例慢性乙型肝炎患者用拉米夫定治疗52-78周后发生YMDD变异的血清标本,对照组128例未用拉米夫定治疗的慢性乙型肝炎患者血清标本,应用聚合酶链反应方法,测定HBV DNA基因型;用限制性片段长度多态性分析方法(PCR RELP)测定HBV DNA YMDD变异;同时进行HBV DNA定量分析.结果显示51例拉米夫定治疗后HBV DNA基因变异患者以B型和C型为主,分别为10例(19.6%)和39例(76.47%),B C混和型2例(3.92%),未见其它基因型.拉米夫定治疗引起HBVDNAYMDD变异可以发生在不同HBV基因型感染的慢性乙型肝炎患者中,与对照组比较二者没有显著性差异.     

重组α-1b干扰素治疗慢性乙型肝炎110例临床观察

目的观察不同状况的慢性乙型肝炎与干扰素联合应答之间的关系。方法将110例接受重组α-1b干扰素治疗的慢性乙型肝炎患者,分别按性别、是否母婴传播、ΑLT水平、HBVDNA定量、是否联合用药、药物的剂量和疗程进行分组,观察其联合应答率。结果非母婴传播者、治疗前ΑLT2～5×ULN、HBVDNA<107copies/ml、疗程1年以上者联合应答率较高;未见性别对干扰素疗效的影响;干扰素3MU与5MU剂量之间,以及联合用药与非联合用药之间,疗效无明显差异。结论非母婴传播者、治疗前ALT为2～5 ×ULN、HBVDNA<107copies/ml、疗程1年以上者应用干扰素治疗疗效较好,可作为干扰素疗效的预测因子。     

Long-term suppression of hepatitis B e antigen-negative chronic hepatitis B by 24-month interferon therapy

To assess whether extended treatment with interferon improves the outcome of hepatitis B e antigen (HBeAg)-negative chronic hepatitis B, 101 consecutive patients were treated with 6 MU of interferon alfa 2b 3 times weekly for 24 months. During the 68-month study, 30 patients (30%) had a sustained response (i.e., normal serum transaminase levels and undetectable hepatitis B virus DNA by non-polymerase chain reaction [PCR] assays), and 15 cleared serum surface antigen. Twenty-five nonresponders, 16 relapsers, and 30 who discontinued treatment were considered treatment failures. Multivariate analysis predicted a sustained response for young age (odds ratio, 0.94; 95% confidence interval, 0.89-0.99; P =.041) and high pretreatment serum levels of immunoglobulin M (IgM) anti-hepatitis B core antigen (HBc) (odds ratio, 4.52; 95% confidence interval, 1.63-12.5; P =.004). Liver disease progressed in none of the sustained responders but in 16 with treatment failure (0% vs. 22%, P =.002); hepatocellular carcinoma (HCC) developed with similar frequency in both groups (7%). Overall, estimated 8-year complication-free survival was longer for the 30 sustained responders than the 71 patients with treatment failure (90% vs. 60%, P <.001), but 8-year patient survival was similar in the 2 groups (100% and 90%). Short complication-free survival was predicted by failure to respond to interferon (hazard ratio, 7.8; 95% confidence interval, 1.8-34.0; P =.006) and high scores for liver fibrosis (hazard ratio, 1.71; 95% confidence interval, 1.17-2.50; P =.005). In conclusion, 24 months of treatment with interferon alfa 2b led to sustained disease suppression in a significant proportion of patients with HBeAg-negative chronic hepatitis B.     

α-干扰素与拉米夫定联合治疗慢性乙型肝炎的疗效观察

目的对比观察单用拉米夫定与其联合α干扰素治疗慢性乙型肝炎的疗效和安全性。方法拉米夫定组56例,给予拉米夫定100mg/日,服用12～15个月;联合组54例,给予拉米夫定100mg/日,两周后联合α干扰素3～5MU肌肉注射,每周3次,连用6个月,继续服用拉米夫定100mg/日,至12～15个月。并继续随访6个月,观察治疗6个月、12个月治疗结果。结果拉米夫定组和联合组6个月时HBVDNA阴转率分别为96.7%和97.8%;ALT/AST复常率分别为88.5%/90.5%和88%/93.1%(P>0.05);HBeAg的血清学转换率分别为22%和29.3%(P>0.05)。12个月时两组ALT/AST复常率为91%/91.6%和89%/92.5%(P>0.05);HBeAg血清学转换率为40%和56%,P<0.05。结论拉米夫定联合干扰素治疗慢性乙型肝炎,安全性、耐受性良好。联合组治疗1年后HBeAg血清转换率明显高于单用拉米夫定组。     

胸腺肽联合乙肝疫苗治疗干扰素无应答的慢性乙型肝炎疗效观察

观察胸腺肽联合乙肝疫苗对干扰素治疗后无应答的慢性乙型肝炎的疗效。分为胸腺肽加乙肝疫苗联合组４２例，胸腺肽组３０例，乙肝疫苗组２６例，护肝组２５例仅使用一般性保肝药物。疗程为６个月。结果ＨＢｅＡｇ／抗－ＨＢｅ转换率联合组４２．６％，胸腺肽组３０．０％，乙肝疫苗组１５．４％，联合组比后二者具有显著性差异（Ｐ＜０．０５）． ＨＢＶ－ＤＮＡ阴转率联合组 ５２．４％，胸腺肽组３６．７％，乙肝疫苗组 １９．２％，护肝组４．０％（Ｐ＜０．０１）。说明胸腺肽联合乙肝疫苗对干扰素治疗无应答的慢性乙型肝炎可取得较好疗效．     

Long-term effect of low dose recombinant interferon therapy in patients with chronic hepatitis B

Thirty three heterosexual chronic hepatitis B virus (HBV) carriers were randomized, with stratification for disease activity, to receive intramuscular recombinant interferon alpha-2a (r-IFN) at doses of 4.5 megaunits thrice weekly for 4 months, or no treatment. During r-IFN treatment, serum HBV-DNA levels fell in all, but 2 patients. Final evaluation at 16 months after randomization revealed that the rate of complete response, i.e., loss of both HBV-DNA and HBeAg with ALT normalization was 22.2% (2 of 9 cases) in patients on interferon and 12.5% (1 of 8 cases) in untreated patients for the group with high serum alanine aminotransferase (ALT) and with piecemeal necrosis on liver biopsy on entry. The corresponding value was 25% (2 of 8 cases) in treated and 12.5% (1 of 8 cases) in untreated patients with low liver disease activity. Overall, a complete response was thus observed in 23.5% of treated patients and in 12.5% of controls. None of the patients on therapy became HBsAg negative. It is concluded that treatment of heterosexual patients with chronic hepatitis B with r-IFN in the dose regimen used here was not associated with a significant higher rate of serologic and clinical response compared to controls, independently of pretreatment biochemical and histologic activity of liver disease.     

Recombinant leukocyte interferon treatment of chronic hepatitis B

We have investigated the efficacy of a relatively prolonged course of recombinant leukocyte interferon treatment in 14 chronic HBsAg-, HBeAg-, hepatitis B virus DNA- and DNA polymerase-positive carriers. alpha-Interferon was administered for 9 weeks. Six of 14 treated carriers have a sustained loss of HBeAg, hepatitis B virus DNA and DNA polymerase. Four subsequently lost HBsAg (28.5%). Elevated pretreatment SGPT concentrations, histologic chronic active hepatitis, an exacerbation of chronic hepatitis with an increase in SGPT concentrations in the last weeks of treatment and possibly recent onset of the carrier state was associated with complete inhibition of viral replication. None of 11 matched, untreated HBsAg-, HBeAg-, hepatitis B virus DNA- and DNA polymerase-positive carriers monitored during the same period lost HBsAg. The effect of recombinant leukocyte interferon may require an appropriate host-immune response. The efficacy of recombinant leukocyte interferon therapy is restricted, but it may be of benefit in a proportion of carriers, if these carriers can be precisely identified.