标题:慢性乙型肝炎干扰素治疗的效果及无应答患者的影响因素分析
作者:甄海洋,朱宁
(榆林市第四医院 星元医院消化内科,陕西 榆林 719000)
卷次:
2016年27卷6期
【摘要】 目的 探讨干扰素-α (IFN-α)治疗慢性乙型肝炎的临床疗效,并分析影响患者病毒学应答的相关因
素。方法 选取我院2012年5月至2014年5月收治的87例慢性乙型肝炎作为研究对象,均给予 IFN-α治疗,治疗
48周后观察患者血清谷丙转氨酶(ALT)复常率、血清乙肝病毒(HBV-DNA)转阴率、乙型肝炎 e抗原(HBeAg)血清转
换率,并采用多因素Logistic回归分析法分析影响患者病毒学无应答的相关因素。结果 治疗24、36、48周后,患
者HBV-DNA转阴率(63.22%,71.26%,73.56% vs 33.33%)、HBeAg血清转换率(47.13%,49.43%,54.02% vs 13.79%)
均高于治疗 12周时(P<0.05);87例患者中应答 64例(73.56%),无应答 23例(26.44%);单因素分析结果显示,ALT、
HBV-DNA载量与干扰素治疗后无应答相关 (P<0.05);多因素 Logistic回归分析结果显示,ALT (OR=4.334)、
HBV-DNA载量(OR=7.157)是干扰素治疗后无应答的独立危险因素(P<0.05)。结果 干扰素可作为慢性乙型肝炎
治疗的常规用药,且随疗程的增长其临床疗效提高;治疗前低ALT水平、高HBV-DNA载量是影响慢性乙型肝炎患
者干扰素无应答的重要因素。
【关键词】 慢性乙型肝炎;干扰素;临床疗效;无应答;影响因素
【中图分类号】 R512.6+2 【文献标识码】 A 【文章编号】 1003—6350(2016)06—0912—03
Effect of interferon in the treatment of chronic hepatitis B and the influencing factors of non-responsive patients.
ZHEN Hai-yang, ZHU Ning.
Department of Gastroenterology, the Fourth Hospital of Yulin City, Yulin 719000, Shaanxi,
CHINA
【Abstract】 Objective To investigate the clinical efficacy of interferon alpha (IFN-α) in the treatment of chron-
ic hepatitis B, and to analyze the related factors affecting virological non-response. Methods From May 2012 to May
2014, eighty-seven patients of chronic hepatitis B were selected as the research subjects, which were all given IFN-α
treatment. After 48 weeks of treatment, the serum alanine aminotransferase (ALT), recovery rate, negative rate of serum
hepatitis B virus (HBV) DNA, serum conversion rate of hepatitis B e antigen (HBeAg) were observed. Multiple logistic
regression analysis was used to analyze the related factors of virological non-response. Results After 24, 36 and 48
weeks of treatment, the negative rate of HBV-DNA (63.22%,71.26%,73.56% vs 33.33% ), serum conversion rate of
HBeAg (47.13%,49.43%,54.02% vs 13.79%) were significantly higher than those after 12 weeks of treatment (P<0.05).
Among the 87 patients, 64 had response (73.56%) and 23 had no response (26.44%). Single factor analysis showed that
ALT, HBV-DNA load were related to the non-response after interferon therapy (P<0.05). Multivariate logistic regression
analysis showed that, HBV-DNA load (OR=7.157) and ALT (OR=4.334) were the independent risk factors of non-re-
sponse after interferon therapy (P<0.05). Conclusion Interferon can be used as a routine treatment for chronic hepatitis
B, and the clinical effect is increased with the increase of the course of treatment. Before treatment, the low ALT level
and high HBV-DNA load are the important factors that affect the non-response of interferon in patients with chronic hep-
atitis B.
【Key words】 Chronic hepatitis B; Interferon; Clinical effect; Non-response; Influencing factors
·论 著·
6350.2016.06.018
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