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时间:2020-05-23
《联合核苷类药物治疗干扰素应答不佳的慢性乙型肝炎时机选择及疗效研究.pdf》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、中西医结合肝病杂志2014年第24卷第3期·141··临床研究·doi:10.3969/j.issn.1005-0264.2014.03.005联合核苷类药物治疗干扰素应答不佳的慢性乙型肝炎时机选择及疗效研究林占洲刘彩霞卢雪兰何伟峰余治健1.惠州市中心人民医院肝病科(广东惠州,516001)2.惠州市第三人民医院消化科3.广东医学院附属深圳市南山区人民医院内源性感染诊治研究重点实验室摘要目的:探讨干扰素治疗HBeAg阳性慢性乙型肝炎时,联合核苷(酸)类药物的不同时机对治疗应答的影响。方法:观察干扰素治疗患者分别在治疗起始时联合阿德福韦酯、l2周应答不佳者及24周应答
2、不佳者联合拉米夫定最终各组疗效。结果:48周时及停药后24周时,起始时联合阿德福韦酯治疗组及12周应答不佳者联合拉米夫定组患者的病毒转阴率、ALT复常率、HBeAg转阴率均高于对照组(P<0.05),而HBeAg转换率并未有明显提高(P>0.05)。结论:治疗起始干扰素联合阿德福韦酯或根据12周应答情况加用拉米夫定治疗均能一定程度提高治疗应答率。关键词肝炎,乙型,慢性;干扰素/治疗应用;核苷类药物/治疗应用;联合治疗Theopportunityandefectofnucleosideanaloguecombinedwithinterferonf0rtreatingc
3、hronichepatitisBvirusinfectionLINZhan-zhou,Cai.xia,LUXue1an,eta1.HuizhouMunicipalCentralHospital(HuizhouGuangdong,516001)ChinaAbstractObjective:Toobservetheefficacyandtheopportunityofnucleosideanalognecombinedwithinterferonintreat-mentofHBeAg—positivechronichepatitisBpatients.Methods:N
4、inetytwocasesofHBeAg—positivechronichepatitisBpa-tientsweredividedinto4groups:interferonmonotherapygroup(n=25),interferonplusADVdenovocombinationtherapygroup(n=25),interferonplusLAMcombinationtherapyat12weeksgroup(thepatientswithoutearlyviralresponses,n=22),interferonplusLAMcombination
5、therapyat24weeksgroup(thepatientswithoutvimlo~calresponse,n=20).Allpa—tientsweretreatedwithinteferonfor48weeks.ThepercentsofHBeAgclearanceorseroconversion,ALTnormalizationandan—detectableHBVDNAwereevaluated.Results:Comparedwithinterferonmonotherapygroup,thepercentagesofHBeAgclear-ance,
6、undetectableHBVDNAandALTnormalizationinADVcombinationtherapygrouporLAMcombinationtherapyat12weeksgroupwassignificantlyimproved,however,nodiferenceofHBeAgseroconversionoccurrencesamongthesethreegroups·Conclusion:Efficacyofadefovirdipivoxilcombinationwithinterferontherapyorlamivudinecomb
7、inationwithinterfcroBat12weekstherapyissuperiortointerferonmonotherapyinHBeAg—positivechronichepatitisBpatients.KeyWordschronichepatitisB;interferon/therapeuticapplication;nucleosideanalogue/therapeuticapplication;combi-nationtherapy干扰素及核苷药类物是目前公认用于慢性乙型肝炎满意。如何在相对固定的疗程中提高应答率、提高疗效是临(CH
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