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目的探讨聚乙二醇干扰素治疗HBe Ag阳性慢性乙肝52周部分应答患者换用替比夫定的疗效及安全性。方法对聚乙二醇干扰素治疗HBe Ag阳性慢性乙肝52周时部分应答患者改用替比夫定(600 mg、1/d)继续治疗,分别于0、12、24、36及48周检测HBe Ag、HBs Ag、HBV DNA、血清谷丙转氨酶(ALT)及肌酸激酶水平。结果基线ALT水平影响干扰素抗病毒疗效(P=0.026)。换用替比夫定治疗后,血清HBV DNA在24周时全部阴转,HBe Ag转换率由12周时的31.3%,增至48周时的62.5%,HBs Ag水平进一步降低,治疗过程中无明显不良反应。结论干扰素部分应答患者换用替比夫定能使HBV DNA及HBs Ag水平进一步降低,提高HBe Ag血清学转换率,安全性好,值得借鉴。
Objective To investigate the efficacy and safety of pegylated interferon in the treatment of 52-week HBeAg-positive chronic hepatitis B patients responding to telbivudine. Methods The partial response to peginterferon in HBeAg-positive chronic hepatitis B patients was treated with telbivudine (600 mg, 1 / d) for 52 weeks. At week 0, 12, 24, 36 and 48 HBeAg, HBs Ag, HBV DNA, serum alanine aminotransferase (ALT) and creatine kinase. Results Baseline ALT levels affected the efficacy of interferon antiviral therapy (P = 0.026). After switching to telbivudine, serum HBV DNA was completely negative at 24 weeks, and the HBe Ag conversion rate increased from 31.3% at 12 weeks to 62.5% at 48 weeks. The level of HBs Ag was further reduced during treatment No obvious adverse reactions. Conclusion Interferon partial response patients to telbivudine can further reduce the levels of HBV DNA and HBsAg, improve the seroconversion rate of HBeAg, safety is worth learning from.