阿德福韦酯联合INFα对慢性乙型肝炎治疗研究.docVIP

阿德福韦酯联合INFα对慢性乙型肝炎治疗研究 　　摘要: 目的:观察阿德福韦酯联合INF-α对慢性乙型肝炎(CHB)的疗效及对乙型 肝炎病毒脱氧核糖核酸(HBV DNA)的影响。方法:184例CHB患者随机分为治疗组和对照组 ,治疗组92例为阿德福韦酯和INF-α;对照组92例为单用阿德福韦酯,疗程均为12个月, 每 3个月分别检测肝功能#65380;乙型肝炎病毒血清学标志物#65380;HBV DNA。其中40例患者(每组20例 )进行治疗前#65380;后两次肝穿活检。结果:在治疗12个月时,治疗组和对照组的HBV DNA差 异有显著性意义(P0.05),治疗组的HBV DNA表达量明显低于对照组,大部分患者肝组 织病 理有改善。结论:阿德福韦酯联合INF-α能在一定程度上提高治疗CHB的疗效,而其对HBVDNA的影响有待进一步的研究。 　　关键词:慢性乙型肝炎;HBV DNA;阿德福韦酯;INF-α 　　中图分类号: R512.62 文献标识码: A 文章编号: 1008-2409(2009)05-0814-03 　　 　　Effect of INF-α and Adefovir combination therapy on patients with chronichep atitis B/ZHU Yu-jia∥Guigang Hospital Affiliated to Guangxi TCM University, Guigang 537100, China 　　Abstract:Objective:To observe the effect of combined application of INF-αand Adefovir in treating patients with chronic hepatitis B(CHB)and its influe nce on HBV DNA. Methods:184 patients were enrolled and randomized into two grou ps:the treated group(92 cases)and control group(92cases). The treated groupreceived INF-α and Adefovir simultaneously for 12 months. The control group re c eived Adefovir alone for 12 months. Liver function,virological parameters,seru mHBV DNA and HBV DNA were evaluated. Liver biopsy was taken before therapy and a fter 12 month treatment in 40 patients. Results:After 12 months treatment,ther e w as no difference in HBV DNA negative rate between treated group and control grou ps(P0.05).Most of liver histology were improved in 40 patients. Conclusio n: Combined application of INF-α and l Adefovir could enhance the therapeutic eff e ct in treating CHB to certain extent,but effect on HBV DNA should be study furt her more. 　　Key words: chronic hepatitis B;HBV DNA;Adefovir;INF-α 　　 　　阿德福韦酯在CHB抗病毒治疗上的广泛应用是近年来CHB治疗上的重大进展,对控 制病情#65380;改善肝组织及预后均有良好的作用。免疫调节剂可以提高人体的免疫功能,尤其是 对HBV的特异性免疫;免疫调节剂还可以识别和破坏HBV感染的靶细胞,达到清除HBV的目的 。本研究采用抗乙肝病毒药物联合应用免疫调节剂的方法,通过观察阿德福韦酯联合INF- α治疗CHB的疗效及对HBV DNA的影响,以探讨CHB抗病毒治疗上联合用药的方法。 　　 　　1 资料与方法 　　 　　1.1 病例选择 　　收集我院2006年6月至2007年6月184例(CHB)患者,男118例,女6 6例;年龄16 ~60岁,诊断符合2004年中华医学会西安会议修