聚乙二醇干扰素α-2a联合富马酸替诺福韦二吡呋酯治疗HBeAg阳性初治慢性乙型肝炎患者的临床效果

doi:10.3969/j.issn.1671-7171.2025.06.025

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摘要【目的】探讨聚乙二醇干扰素α-2a联合富马酸替诺福韦二吡呋酯治疗乙型肝炎病毒e抗原(HBeAg)阳性初治慢性乙型肝炎(CHB)患者的临床效果。【方法】选取2021年6月至2024年5月本院收治的76例HBeAg阳性初治的CHB患者,采用随机数字表法将其分为观察组与对照组,每组38例。对照组给予富马酸替诺福韦二吡呋酯治疗,观察组在对照组基础上联合聚乙二醇干扰素α-2a治疗,两组均连续治疗48周。比较两组临床疗效[乙肝病毒载量(HBV-DNA)阴转率、病毒学应答率、HBeAg阴转率、HBsAg血清学转化率]及用药不良反应,比较治疗前后HBV-DNA、HBeAg、丙氨酸转氨酶(ALT)水平、肝纤维化指标[透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原蛋白(PCⅢ)、Ⅳ型胶原蛋白(C-Ⅳ)]、炎症因子[白介素-17(IL-17)、白介素-4(IL-4)、干扰素-α(IFN-α)]水平。【结果】观察组HBV-DNA阴转率、HBeAg阴转率、病毒学应答率、HBsAg血清学转化率显著高于对照组,差异有统计学意义(P<0.05)。治疗后,两组HBV-DNA、HBeAg、ALT水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组HA、LN、PCⅢ、C-Ⅳ水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组IL-17、IL-4低于治疗前,IFN-α高于治疗前,差异有统计学意义(P<0.05);观察组IL-17、IL-4低于对照组,IFN-α高于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】聚乙二醇干扰素α-2a联合富马酸替诺福韦二吡呋酯治疗HBeAg阳性初治CHB的临床效果较好,可抑制肝脏纤维化进展及炎症反应,且安全性较高。

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	谭风雷
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关键词 ：乙型肝炎, 慢性, 乙型肝炎e抗原, 干扰素α2, 治疗结果

Abstract：【Objective】To investigate the clinical efficacy of pegylated interferon α-2a combined with tenofovir disoproxil fumarate in the treatment of hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) patients. 【Methods】A total of 76 newly diagnosed CHB patients with HBeAg positivity admitted to our hospital from June 2021 to May 2024 were randomly divided into the observation group and the control group using a random number table method, with 38 patients in each group. The control group was treated with tenofovir disoproxil fumarate, while the observation group was treated with pegylated interferon alpha-2a in addition to the control group. Both groups were treated continuously for 48 weeks. The clinical efficacy [negative conversion rate of hepatitis B virus load (HBV-DNA), virological response rate, negative conversion rate of HBeAg, serological conversion rate of HBsAg] and adverse drug reactions of the two groups were compared, and the levels of HBV-DNA, HBeAg, ALT, liver fibrosis indicators [hyaluronic acid (HA), laminin (LN), type Ⅲ procollagen (PC Ⅲ), type Ⅳ collagen (C-Ⅳ)], inflammatory factors [interleukin-17 (IL-17), interleukin-4 (IL-4), interferon-α(IFN-α)] before and after treatment were compared in the two groups. 【Results】The HBV-DNA negative conversion rate, HBeAg negative conversion rate, virological response rate, and HBsAg seroconversion rate in the observation group were significantly higher than those in the control group, and the differences were statistically significant (P<0.05). After treatment, the levels of HBV-DNA, HBeAg, and ALT in both groups were lower than those before treatment, and the levels of HBV-DNA, HBeAg, and ALT of the observation group was even lower than those of the control group, with statistical significance (P<0.05). After treatment, the levels of HA, LN, PC Ⅲ, C-Ⅳ in both groups were lower than those before treatment, and the levels of HA, LN, PC Ⅲ, C-Ⅳof the observation group was lower than those of the control group, with statistical significance (P<0.05). After treatment, IL-17 and IL-4 levels in both groups were lower than those before treatment, while IFN-α levels were higher than that before treatment, with statistically significant differences (P<0.05); The levels of IL-17 and IL-4 in the observation group were lower than those in the control group, while IFN-α was higher than that in the control group, and the differences were statistically significant (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】The clinical effect of pegylated interferon alpha-2a combined with tenofovir disoproxil fumarate in the treatment of HBeAg positive initial CHB is good. It inhibits the progression of liver fibrosis and inflammatory response, and has high safety.

Key words： Hepatitis B, Chronic Hepatitis B e Antigens Interferon alpha-2 Treatment Outcome

收稿日期: 2024-12-14

中图分类号:

R512.62

引用本文:

谭风雷, 赵敏. 聚乙二醇干扰素α-2a联合富马酸替诺福韦二吡呋酯治疗HBeAg阳性初治慢性乙型肝炎患者的临床效果[J]. 医学临床研究, 2025, 42(6): 1000-1003.
TAN Fenglei, ZHAO Min. Clinical Observation of Pegylated Interferon α-2a Combined with Tenofovir Disoproxil Fumarate in the Treatment of HBeAg-Positive Chronic Hepatitis B Patients. JOURNAL OF CLINICAL RESEARCH, 2025, 42(6): 1000-1003.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.06.025 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I6/1000

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