"领跑者5000(F5000)"是由我国最权威的科技信息研究机构——中国科学技术信息研究所负责评选,入选论文均为各学科前1%高被引论文,展现了期刊所在学科领域的最高学术成果。
,《临床肝胆病杂志》被提名F5000论文共13篇,在入选“中国精品科技期刊”的3种消化病学类期刊中排名第1位。
干扰素联合核苷(酸)类似物治疗慢性乙型肝炎的疗效观察
何艳, 唐晓鹏, 郑宣鹤, 姚运海, 张权, 张永红, 陈军
中南大学湘雅二医院
目的观察干扰素(IFN)与核苷(酸)类似物联合治疗慢性乙型肝炎的疗效。
方法选择慢性乙型肝炎病例207例,分别予聚乙二醇干扰素(PEG- IFNα- 2a 或 IFNα- 2b)治疗52周,随访24周,其中146例(A组)初始24周联合核苷(酸)类似物治疗(59例联合拉米夫定,56例联合阿德福韦酯,31例联合恩替卡韦),另61例单用IFN治疗(B组)。
结果A、B组治疗结束时HBV DNA阴转率分别为86.3%(126/146)、65.6%(40/61);ALT复常率87.7%(128/146)、76.5%(39/61);HBeAg阴转率分别为69.3%(70/101)、40%(10/25);HBsAg阴转率分别为30.1%(44/146)、16.4%(10/61);抗-HBs阳转率分别为26.7%(39/146)、11.5%(7/61),差异均有统计学意义(P<0.05)。
结论IFN联合核苷(酸)类似物治疗慢性乙型肝炎的疗效优于单用IFN组。
ObjectiveTo observe the therapeutic efficacy of combination therapy with interferon (IFN) and a nucleoside analogue for treating chronic hepatitis B (CHB) patients.
MethodsTwo-hundred-and-seven patients diagnosed with CHB were assigned to the following treatment groups: IFN in combination with a nucleoside analogue (group A); IFN monotherapy (group B). The patients in group A were further divided into three combination treatment sub-groups, according to the particular nucleoside analogue administered: lamivudine (LAM; sub-group A1, n=59); adefovir dipivoxil (ADV; sub-group A2, n=56); and entecavir (ETV; sub-group A3; n=31). All of the patients received pegylated-IFN (either IFN -2a or IFN -2b) for 52 weeks. The patients in group A received the combination therapy with nucleoside analogue immediately upon initiation of the IFN treatment and lasting for a total of 24 weeks, after which IFN monotherapy was carried out.
ResultsIn groups A and B, respectively, 86.3% and 65.6% achieved undetectable levels of HBV DNA at the end of treatment. However, group A achieved a higher rate of alanine aminotransferase (ALT) normalization rate (87.7% vs. group B: 765%, P<0.05). Group A also achieved a significantly higher rates of hepatitis B e antigen (HBeAg) clearance (69.3% vs. group B: 40%, P<0.05), hepatitis B surface antigen (HBsAg) clearance (30.1% vs. group B: 16.4%, P<0.05), and HBsAg seroconversion (26.7% vs. group B: 11.5%, P<0.05).
ConclusionThe combination treatment of IFN plus a nucleoside analogue is more efficacious than IFN monotherapy for treating CHB patients.
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