聚乙二醇干扰素α-2a联合恩替卡韦治疗慢性乙型肝炎患者疗效及血清Pygo2和GP73水平变化

doi:10.3969/j.issn.1672-5069.2021.01.006

摘要/Abstract

摘要： 目的分析聚乙二醇干扰素α-2a联合恩替卡韦治疗慢性乙型肝炎(CHB)患者的疗效及血清人尾肢同源蛋白2(Pygo2)和高尔基体糖蛋白73(GP73)水平的变化。方法 2018年2月~2019年2月我院收治的77例CHB患者,采用随机数字表法分为对照组36例和观察组41例,分别给予恩替卡韦或恩替卡韦联合聚乙二醇干扰素α-2a治疗24 w。采用聚合酶链式反应检测血清HBV DNA,采用化学发光法检测血清HBeAg和抗HBe,采用ELISA法检测血清Ⅲ型前胶原(PCⅢ)、层粘连蛋白(LN)、透明质酸(HA)和Ⅳ型胶原(Ⅳ-C)及Pygo2和GP73水平。结果在治疗结束时,两组血清HBV DNA转阴率均为100.0%,但观察组血清HBeAg转阴率为36.6%,显著高于对照组(19.4%,P<0.05),HBeAg血清转换率为22.0%,显著高于对照组(8.3%,P<0.05);观察组血清ALT水平为(32.3±13.5)U/L,显著低于对照组【(46.1±19.7)U/L,P<0.05】;观察组患者血清LN水平为(84.7±31.5)μg/L,显著低于对照组【(117.6±40.3)μg/L,P<0.05】,Ⅳ-C水平为(79.8±16.1)μg/L,显著低于对照组【(97.4±19.5)μg/L,P<0.05】,PC-Ⅲ水平为(94.5±21.2)μg/L,显著低于对照组【(140.8±29.7)μg/L,P<0.05】,和HA水平为(107.1±25.2)μg/L,显著低于对照组【(160.5±35.0)μg/L,P<0.05】;观察组患者血清Pygo2水平为(50.8±5.9)μg/L,显著低于对照组【(55.4±7.3)μg/L,P<0.05】,GP73水平为(108.6±10.6)ng/mL,显著低于对照组【(121.5±13.2)ng/mL,P<0.05】。结论联合应用恩替卡韦和聚乙二醇干扰素α-2a治疗CHB患者可取得比单用恩替卡韦更好的短期疗效,可能与联合治疗能有效降低血清Pygo2和GP73水平,缓解肝纤维化进程,从而显著改善肝功能和提高了血清学应答有关。

关键词: 慢性乙型肝炎, 聚乙二醇干扰素α-2a, 恩替卡韦, 人尾肢同源蛋白2, 高尔基体糖蛋白73, 治疗

Abstract: Objective The aim of this study was to analyze the serological and virological response to pegylated interferon α-2a (peg-IFN-α-2a) and entecavir combination in patients with chronic hepatitis B (CHB). Methods 77 patients with CHB were recruited in this study between February 2018 and February 2019, and divided randomly into control group (n=36) and observation group (n=41) . The patients in the control group were treated with entecavir, and those in the observation group were treated with peg-IFN-α-2a and entecavir combination for 24 weeks. Serum HBV DNA loads were detected by polymerase chain reaction, serum HBeAg and anti-HBe were detected by chemiluminescence method, and serum procollagen type III (PC III), laminin (LN), hyaluronic acid (HA), collagen type IV (IV-C), people end limb homologous protein 2 (Pygo2) and Golgi glycoprotein 73 (GP73) levels were detected by ELISA. Results At the end of 24 week treatment, serum HBV DNA negativity rates in the two groups were 100.0% vs. 100.0%, while serumHBeAg negativity rate in the observation group was 36.6%, significantly higher than that in the control group (19.4%, P<0.05), and serum HBeAg conversion to anti-HBe rate was 22.0%, significantly higher than that in the control group (8.3%, P<0.05); serum ALT level in the observation group was (32.3±13.5) U/L, significantly lower than that in the control group ; serum LN level in the observation group was (84.7±31.5) μg/L, significantly lower than that in the control group , Ⅳ-C level was (79.8±16.1) μg/L, significantly lower than that in the control group , PC-Ⅲ level was (94.5±21.2) μg/L, significantly lower than that in the control group , and serum HA levels was (107.1±25.2) μg/L, significantly lower than that in the control group ; serum Pygo2 level in the observation group was (50.8±5.9) μg/L, significantly lower than that in the control group , and serum GP73 level was (108.6±10.6) ng/mL, significantly lower than that in the control group .Conclusion The combination of entecavir and pegylated interferon α-2a for the treatment of patients with CHB could effectively improve serological and virological response, which might be related to the reduction of serum levels of Pygo2 and GP73 and relieve liver fibrosis.

Key words: Hepatitis B, Pegylated interferon α-2a, Entecavir, People end limb homologous protein 2, Golgi glycoprotein 73, Therapy

郑志恒, 李维筠, 回振宇, 陈莹. 聚乙二醇干扰素α-2a联合恩替卡韦治疗慢性乙型肝炎患者疗效及血清Pygo2和GP73水平变化[J]. 实用肝脏病杂志, 2021, 24(1): 19-22.

Zheng Zhiheng, Li Weiyun, Hui Zhenyu,et al. Serological and virological response topegylated interferon α-2a and entecavir combination in patients with chronic hepatitis B[J]. Journal of Practical Hepatology, 2021, 24(1): 19-22.

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