聚乙二醇干扰素α-2a联合乙肝疫苗治疗慢性乙型肝炎疗效观察

目的：探讨聚乙二醇干扰素α-2a （PEG-IFNα-2a）联合乙肝疫苗治疗慢性乙型肝炎（CHB）的临床疗效及安全性。方法随机将172例CHB患者分为观察组和对照组，每组86例。对照组应用PEG-IFNα-2a治疗，观察组应用PEG-IFNα-2a联合乙肝疫苗治疗。比较两组在治疗6 m、12 m和随访6 m时HBV DNA阴转率、HBeAg阴转率和ALT复常率。结果在治疗12 m和随访6 m时，观察组HBV DNA阴转率、HBeAg阴转率和ALT复常率分别为81.4%、53.5%和82.6%，和93.0%、64.0%和95.3%，均显著高于对照组水平（67.4%、38.7%和68.6%，和75.6%、46.5%和77.9%，P〈0.05）；在治疗6 m、12 m和随访6 m时，观察组ALT和AST水平分别为（93.5±43.1） U/L和（86.0±50.6） U/L、（40.8±25.1） U/L和（50.7±28.6） U/L、（36.5±11.3） U/L和（43.2±15.7）U/L，均显著低于对照组（116.4±58.6） U/L和（105.3±52.8） U/L、（50.6±26.2） U/L和（59.5±25.4） U/L、（46.0±24.4）U/L和（52.6±23.9） U/L，P〈0.05。结论 PEG-IFNα-2a联合乙肝疫苗治疗CHB可有效地提高干扰素的临床疗效。

Combination therapy of pegylated interferon alpha-2a and hepatitis B vaccine in treatment of patients with chronic hepatitis B

Objective To investigate the efficacy and safety of combination therapy of pegylated interferonα-2a（PEG-IFNα-2a）and hepatitis B vaccine in treatment of patients with chronic hepatitis B（CHB）. Methods One hundred and seventy-two patients with CHB in our hospital from October,2008 to October,2012 were recruited and randomly divided into observation group（PEG-IFNα-2a plus hepatitis B vaccine） and control group（PEG-IF-Nα-2a alone,86 cases in each group）;The negative conversion rates of serum HBV DNA and HBeAg,normaliza-tion rates of ALT and adverse events at 6 and 12 months after treatment and at the end of 6-month followed-up between the two groups were compared. Results The negative conversion rates of HBV DNA and HBeAg,and the ALT normalization rates in observation group at 6 and 12 months after treatment and 6 months followed-up were 81.4%,53.5%,82.6% and 93.0%,64.0%,95.3%,respectively,all of which were significantly higher than those of corresponding parameters in control group（67.4%,38.7%,68.6% and 75.6%,46.5%,77.9%,respectively,P〈0.05）;The serum ALT and AST levels at 6 and 12 months after treatment and at 6-month followed-up in observation group were （93.5±43.1） U/L and （86.0±50.6） U/L,（40.8±25.1） U/L and （50.7±28.6） U/L,（36.5±11.3） U/L and （43.2±15.7） U/L,respectively,all of which were significantly lower than those in control group （116.4±58.6） U/L and （105.3±52.8） U/L,（50.6±26.2） U/L and （59.5±25.4） U/L,（46.0±24.4） U/L and （52.6±23.9） U/L,respectively,P〈0.05）. Conclusion Combination therapy of PEG-IFNα-2a with hepatitis B vaccine significantly improved the ef-ficacy of PEG-IFNα-2a in treatment of patients with CHB.