乙肝表面抗原滴度为标准的联合抗病毒治疗的临床研究.docVIP

精品论文 参考文献 乙肝表面抗原滴度为标准的联合抗病毒治疗的临床研究 （1.深圳市第七人民医院内科 检验科 广东 深圳 518081；2.深圳市康宁医院 广东 深圳 518000） 【摘 要】目的：提高HBeAg阳性的慢性乙型肝炎治愈好转率，寻找符合国情的最佳联合治疗方案。方法：在患者知情同意的情况下，选择符合条件的患者90人，分A组（联合治疗组）30人，B组（对照组）30人，C组（对照组）30人。A组以干扰素为基础的联合治疗方法，48周后治疗组按GRT指导原则和起效主次原则进行停药，B对照组单用干扰素治疗，C对照组单用恩替卡韦治疗。24周、48周及72周时进行生物化学、病毒学、血清学评估，应答疗效比较采用X2检验。结果：治疗组与B对照组于72周时HBsAg转阴率，HBeAg转阴率，DNA转阴率分别为33.3%，50.0%，96.7%和10.0%，30.0%，56.7%。两组对比差异有统计学意义（Plt;0.05），治疗组好于B对照组；??疗组与C对照组的HBsAg转阴率，HBeAg转阴率，DNA转阴率分别为33.3%，50.0%，96.7%和0%，10.0%，96.7%。两组对比差异有统计学意义（Plt;0.05），治疗组好于C对照组。结论：乙肝表面抗原滴度为标准的干扰素为基础的联合治疗方案来治疗HBeAg阳性的慢性乙型肝炎不但能提高HBsAg，HBeAg转阴率，而且可降低停药后复发率。但有待更大样本量的随机临床试验证实。 【关键词】慢性乙型肝炎；干扰素；恩替卡韦；乙肝表面抗原滴度；联合治疗 【中图分类号】R446.6 【文献标识码】A 【文章编号】1004-6194（2015）02-0285-02 The Clinical study of the combined antiviral therapy with the hepatitis B surface antigen titer as the standard FU Xiao-yi1,ZHU pin-an,1,HONG ling-ling2 LIN Hai-hua1 （1.Department of Liver Diseases, Shenzhen Seventh Peoples Hospital, Shenzhen 518081,China;2.kangning Shenzhen Hospital，Shenzhen 518000） 【Abstract】Objective :To increase the heal rate of HBeAg positive chronic hepatitis B patients, find the best combination of the therapy under the present national conditions of China. Methods :90 eligible consenting patients were recruited in this study, they were randomly divided into three groups (A,B,C) with 30 cases in each group. Patients in group A were treated with interferon plus entecavir combination therapy for 48 weeks, drug discontinuance strategies was based on the GRT guiding principle and primary-secondary effective principle. Patients in group B and C were treated with interferon and entecavir alone, respectively. The changes in biochemical, virological and serological indicators were evaluated at week 24 , 48 and 72, the results were analyzed using the chi-squared test. Results: The HBsAg negative rate, HBeAg negative conversion rate and HBV DNA seroconversion rates of group A at week72 are 33.3%，50.0%，96.7%, significantly bet