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目的 :比较膦甲酸钠与干扰素联用和单用干扰素治疗慢性乙型肝炎的疗效。方法 :选择慢性乙型肝炎患者 6 1例 ,分为联合组 2 3例和干扰素组 38例 ;联合组用膦甲酸钠 4.8g静滴 ,qd ,疗程 1月 ,合并用干扰素α 1b30 0万u ,im ,隔日 1次 ,疗程 3个月。干扰素组单用干扰素。以谷丙转氨酶 (ALT)、乙肝病毒标志物 (HBVM )、乙肝病毒DNA及前C区基因野生株和变异株为观察指标 ,比较不同治疗方案对指标的影响。结果 :治疗 3个月后联合组与干扰素组对慢性乙肝患者血清HBeAg/抗 HBe转换率分别为 47.8%和 2 8.9% (P >0 .0 5 ) ;对慢性乙肝患者血清HBV DNA的阴转率分别为 6 9.5 %和 34.2 % (P <0 .0 1) ;对慢性乙肝患者HBV前C区基因野生株与变异株总阴转率分别为 6 9.6 %和 36 .8% (P <0 .0 5 )。联合组对慢性乙肝患者的ALT的复常率及HBsAg滴度的降低均强于干扰素组。结论 :膦甲酸钠与干扰素联用有协同作用 ,其抗病毒疗效均优于单用干扰素组。
Objective: To compare the efficacy of foscarnet with interferon and interferon alone in the treatment of chronic hepatitis B. Methods: Sixty-one patients with chronic hepatitis B were selected and divided into 23 cases in combination group and 38 cases in interferon group. The combination group was treated with 4.8 g of foscarnet sodium for intravenous injection qd for 1 month and treated with interferon α 1b30 million u, im, every other day, treatment for 3 months. Interferon group Interferon alone. The ALT, HBVM, HBV DNA and pre-C gene wild-type and mutant strains were used as indexes to compare the effects of different treatment regimens on the indexes. Results: The serum HBeAg / anti-HBe conversion rates of the combination group and the interferon group after treatment for 3 months were 47.8% and 29.9% respectively (P> 0.05); the serum HBV DNA of chronic hepatitis B (P <0.01). The total negative conversion rates of wild-type and mutant strains of HBV before C were 69.6% and 36.8%, respectively (P < 0 .0 5). The combined group of patients with chronic hepatitis B ALT normalization rate and HBsAg titers were lower than the interferon group. Conclusion: The combination of foscarnet with interferon has a synergistic effect, and its antiviral efficacy is better than that of interferon alone.