关键词: 慢性乙型肝炎, 干扰素-α, 恩替卡韦, 治疗, Meta分析

Abstract: Objective To investigate the efficacy of combination therapy of interferon-α（IFN-α） plus entecavir（ETV） or IFN-α monotherapy in the treatment of patients with chronic hepatitis B（CHB）. MethodsArticles published before February 10,2013 in database of PubMed,EMbase,Cochrane Library,China Biology Medicine disc,CNKI and WANFANG were searched. All eligible randomized controlled trials were included. Review Manager. 5.1.0 for Windows was used for Meta-analysis. Results Four articles that met the inclusion criteria were obtained,including a total of 259 patients with chronic hepatitis B,of which 115 received combination therapy and 144 received interferon-α alone. The funnel plot analysis showed that the research was distributed symmetrically with the true value as the center. HBV DNA negative rate in patients in combination therapy was higher than patients receiving monotherapy at 24 w and 48 w,and the differences were statistically significant[78.3%（90/115） vs. 42.4%（61/144）,RR=1.89,95% CI 1.52~2.36,P<0.00001,and 92.6%（88/95）vs. 63.7%（79/124）,RR=1.46,95% CI 1.26~1.70,P<0.00001];serum HBeAg conversion rate in patients in combination therapy group was significantly higher than patients receiving monotherapy at 24 w and 48 w[37.4%（43/115）vs. 27.1%（39/144）,RR=1.46,95% CI 1.03~2.08,P=0.03,and 64.2%（61/95）vs. 39.5%（49/124）,RR=1.55,95% CI 1.19~2.01,P=0.001];ALT normalization rate in patients receiving combination therapy was also significantly higher than in patients with monotherapy at 24 w and 48 w [75.7%（87/115）vs. 45.8%（66/144）,RR=1.71,95% CI 1.39~2.11,P<0.00001,and 93.7%（89/95）vs. 66.1%（82/124）,RR=1.41,95% CI 1.23~1.61,P<0.00001]. Conclusions Efficacy of interferon-α plus entecavir in the treatment of patients with CHB is superior to IFN-α monotherapy.

Key words: Chronic hepatitis B, Interferon-α, Entecavir, Combination therapy, Meta-analysis