干扰素α2b联合拉米夫定治疗慢性乙型肝炎患者血清HBeAg阴转和肝功能的变化

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目的分析抗病毒治疗对慢性乙型肝炎患者HBe Ag阴转及肝功能的影响。方法选择2013年2月至2013年11月在本院进行治疗的慢性乙型肝炎患者130例,随机分为观察组和对照组各65例。给予对照组患者干扰素α2b治疗,观察组在此基础上联合拉米夫定治疗。采用ELISA法检测血清乙型肝炎病毒标记物;采用实时荧光定量PCR法检测HBV DNA,分别在治疗6个月和12个月观察患者肝功能、HBV DNA阴转率和HBe Ag转阴率的变化。结果在治疗6个月时,观察组谷丙转氨酶和谷草转氨酶水平分别为(45.7±23.8)U/L和(62.3±23.7)U/L,显著低于对照组的[(55.8±25.3)U/L和(73.2±25.3)U/L,P<0.05];在治疗12个月时,观察组谷丙转氨酶和谷草转氨酶水平分别为(32.7±19.4)U/L和(46.4±6.3)U/L,显著低于对照组的[(44.6±17.3)U/L和(52.8±5.2)U/L,P<0.05];两组患者血清HBV DNA阴转率和HBe Ag阴转率的差异无统计学差异(P>0.05)。结论抗病毒治疗能够有效地改善慢性乙型肝炎患者肝功能,促进HBe Ag阴转,使用干扰素α2b联合拉米夫定治疗的效果更为显著,且安全性较高。 Objective To analyze the effect of antiviral therapy on HBeAg-negative and liver function in patients with chronic hepatitis B Methods 130 patients with chronic hepatitis B who were treated in our hospital from February 2013 to November 2013 were randomly divided into observation group (65 cases) and control group (65 cases). Patients in the control group were treated with interferon alpha 2b, and the observation group was treated with lamivudine on the basis of this. Serum hepatitis B virus (HBV) markers were detected by ELISA. HBV DNA was detected by real-time fluorescence quantitative PCR. Changes of liver function, HBV DNA negative rate and HBeAg negative rate were observed at 6 and 12 months after treatment . Results At 6 months, the levels of alanine aminotransferase and aspartate aminotransferase in the observation group were (45.7 ± 23.8) U / L and (62.3 ± 23.7) U / L, respectively, which were significantly lower than those in the control group [(55.8 ± 25.3) U / L and (73.2 ± 25.3) U / L respectively, P <0.05]. At 12 months, the levels of alanine aminotransferase and aspartate aminotransferase in the observation group were (32.7 ± 19.4) U / L and (46.4 ± 6.3) U / L, which was significantly lower than that in the control group [(44.6 ± 17.3) U / L and (52.8 ± 5.2) U / L, P <0.05]. The difference between the serum HBV DNA negative rate and the HBeAg negative rate No statistical difference (P> 0.05). Conclusion Antiviral therapy can effectively improve liver function in patients with chronic hepatitis B and promote the negative conversion of HBeAg. The treatment with interferon α2b combined with lamivudine is more effective and safe.
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