恩替卡韦联合聚乙二醇干扰素-α2b治疗代偿期乙型肝炎肝硬化患者疗效研究

doi:10.3969/j.issn.1672-5069.2024.02.017

摘要/Abstract

摘要： 目的探讨应用恩替卡韦(ETV)联合聚乙二醇干扰素-α2b(Peg-IFN-α2b)治疗乙型肝炎肝硬化患者的近期疗效。方法 2019年3月～2021年3月安徽医科大学附属巢湖医院诊治的代偿期乙型肝炎肝硬化患者78例, 被随机分为对照组40例和观察组38例, 分别给予ETV或ETV联合Peg-IFN-α2b治疗24 w, 然后两组均继续接受ETV治疗, 随访至48 w。常规检测肝功能指标、血清肝纤维化指标、血清HBV标志物定量和HBV DNA载量。结果在随访24 w末, 观察组血清白蛋白水平为(45.7±3.2)g/L, 显著高于对照组【(38.5±4.3)g/L, P＜0.05】;观察组血清IV-C、HA、PⅢP和LN水平分别为(154.3±11.7)μg/L、(130.9±17.5)μg/L、(110.6±16.2)μg/L和(152.7±14.3)μg/L, 均显著低于对照组【分别为(200.7±12.4)μg/L、(161.8±18.7)μg/L、(157.4±17.3)μg/L和(200.9±16.3)μg/L, P＜0.05】;观察组血清HBsAg水平为1363.8(623.1, 2767.6) IU/ml, 显著低于对照组【2119.6(1144.9, 5094.3) IU/ml, P＜0.05】, 而血清HBsAg阴转率为15.8%, 显著高于对照组的0.0%(P＜0.05)。结论联合应用ETV和Peg-IFN-α2b治疗代偿期乙型肝炎肝硬化患者可改善血清肝纤维化指标, 提高血清HBsAg阴转率, 可能有助于病情恢复。

关键词: 肝硬化, 乙型肝炎, 恩替卡韦, 聚乙二醇干扰素-α2b, 治疗

Abstract: Objective The aim of this study was to investigate the short-term efficacy of entecavir (ETV) and peginterferon-α 2b (Peg-IFN-α 2b) combination in treatment of patients with hepatitis B-induced liver cirrhosis (LC). Methods 40 patients with compensated hepatitis B-induced LC were randomly assigned to the ETV group (control) and 38 to the combination group (observation) between March 2019 and March 2021. After 24 week treatment, all patients in the two groups received ETV continuously and were followed-up for another 24 weeks. The liver function indexes, liver fibrosis indexes, serum HBsAg and HbeAg quantification and HBV DNA loads were routinely measured. Results At the end of 24 week follow-up, serum albumin level in the observation group was (45.7±3.2)g/L, significantly higher than in the control; serum collagen type IV, hyaluronic acid, procollagen Ⅲ peptide and laminin levels in the observation were (154.3±11.7)μg/L, (130.9±17.5)μg/L, (110.6±16.2)μg/L and (152.7±14.3)μg/L, all significantly lower than[(200.7±12.4)μg/L, (161.8±18.7)μg/L, (157.4±17.3)μg/L and (200.9±16.3)μg/L, respectively, P＜0.05] in the control; serum HBsAg level was 1363.8(623.1, 2767.6) IU/ml, much lower than , while serum HBsAg negative rate was 15.8%, much higher than 0.0%(P＜0.05) in the control group. Conclusion The combination of ETV and Peg-IFN-α 2b in the treatment of patients with compensated hepatitis B LC could decrease serum liver fibrosis markers and increase serum HBsAg negative rates, which might delay the progression of the entity.

Key words: Liver cirrhosis, Hepatitis B, Entecavir, Peginterferon-α 2b, Therapy

李尧, 梁健, 张春, 董静, 陈照林, 周旭, 娄方明, 杨小康, 刘波, 宋海燕. 恩替卡韦联合聚乙二醇干扰素-α2b治疗代偿期乙型肝炎肝硬化患者疗效研究[J]. 实用肝脏病杂志, 2024, 27(2): 226-229.

Li Yao, Liang Jian, Zhang Chun, et al.. Clinical efficacy of entecavir and peginterferon-α2b combination in treatment of patients with compensated hepatitis B-induced liver cirrhosis[J]. Journal of Practical Hepatology, 2024, 27(2): 226-229.

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