替诺福韦联合干扰素α1b治疗慢性乙型肝炎的临床观察
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篇名: 替诺福韦联合干扰素α1b治疗慢性乙型肝炎的临床观察
TITLE:
摘要: 目的:观察替诺福韦联合干扰素α1b治疗慢性乙型肝炎(以下简称“乙肝”)的临床疗效与安全性。方法:96例慢性乙肝患者依据随机数字表法分为对照组、A观察组与B观察组,各32例。对照组患者给予恩替卡韦口服,每次0.5 mg,qd;A观察组患者给予替诺福韦口服,每次1片,qd;B观察组患者在A观察组基础上肌内注射干扰素α1b,每次50 μg,每周3次。3组疗程均为48周。比较3组患者的临床疗效、治疗前后血清肝功能指标、乙肝病毒脱氧核糖核酸(HBV-DNA)阴转率及不良反应发生情况。结果:B观察组患者的总有效率(84.38%)明显高于A观察组(62.60%)和对照组(37.50%),A观察组明显高于对照组,差异均有统计学意义(P<0.05)。与治疗前比较,3组患者治疗后的血清天冬氨酸转氨酶、丙氨酸转氨酶、总胆红素水平均明显下降,且B观察组患者的各项指标均明显低于A观察组和对照组,差异均有统计学意义(P<0.05),而A观察组和对照组之间比较,差异均无统计学意义(P>0.05)。B观察组患者治疗12周和24周的HBV-DNA阴转率均明显高于同期A观察组和对照组,差异均有统计学意义(P<0.05),而A观察组和对照组之间比较,差异均无统计学意义(P>0.05)。3组患者均未见明显不良反应发生。结论:替诺福韦联合干扰素α1b治疗慢性乙肝的临床疗效显著,明显优于单用恩替卡韦和替诺福韦。
ABSTRACT: OBJECTIVE: To observe clinical efficacy and safety of individual antiviral therapy of tenofovir combined with interferon α1b for chronic hepatitis B (CHB). METHODS: 96 CHB patients were randomly divided into control group, observation group A and observation group B, with 32 cases in each group. Control group was given entecavir orally, 0.5 mg, qd; observation group A was given tenofovir orally, 1 piece, qd; observation group B was additionally given interferon α1b, 50 μg, 3 times a week, on the basis of observation group A. The treatment course lasted for 48 weeks in 3 groups. Clinical efficacy of 3 groups was compared, and the changes of serum liver function indexes, HBV-DNA negative conversion rate and the occurrence of ADR were compared before and after treatment. RESULTS: The total effective rate of observation group B (84.38%) was significantly higher than that of observation group A (62.60%) and control group (37.50%), and that of observation group A was significantly higher than control group, with statistical significance (P<0.05). Compared with before treatment, the serum levels of AST, ALT and TBIL were significantly decreased after treatment in 3 groups; the observation group B were significantly lower than those of observation group A and control group, with statistical significance (P<0.05); there was no statistical significance between observation group A and control group (P>0.05). The negative rate of HBV-DNA in observation group B were significantly higher than those in control group and observation group A after 12 and 24 weeks of treatment, with statistical significance (P<0.05); there was no statistical significance between observation group A and control group (P>0.05). No obvious ADR was found in 3 groups. CONCLUSIONS: Tenofovir combined with interferon α1b shows significant clinical efficacy for CHB, and is significantly better than that of entecavir and tenofovir alone.
期刊: 2016年第27卷第17期
作者: 李献平,赵鸿霞,张勤俭,李丽芳,宁振海
AUTHORS: LI Xianping,ZHAO Hongxia,ZHANG Qinjian,LI Lifang,NING Zhenhai
关键字: 替诺福韦;干扰素α1b;恩替卡韦;慢性乙型肝炎
KEYWORDS: Tenofovir; Interferon α1b; Entecavir; Chronic hepatitis B
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