聚乙二醇干扰素α-2a治疗老年慢性乙型病毒性肝炎的临床分析.docVIP

·临床研究· 聚乙二醇干扰素α-2a治疗老年慢性乙型病毒性肝炎的临床分析 周 虹 ，伍仕敏1，马 威2* （1武汉市医疗救治中心检验科，武汉430023；2武汉市第一医院中心实验室，武汉 430022） 【摘 要】目的 探讨聚乙二醇干扰素 α-2a在60岁老年乙型肝炎患者中抗病毒治疗的有效性和安全性。方法 选取2009年4月至2013年4月武汉市医疗救治中心收治的62例老年慢性乙型病毒性肝炎患者为老年组，同期65例非老年患者为对照组。两组均接受聚乙二醇干扰素α-2a 180μg，皮下注射，每周1次，治疗48周。结果 老年人乙型肝炎e抗原（HBeAg）阳性和HBeAg阴性组早期病毒学应答（4%，5.4%）低于对照组（25.92%，21.05%），HBeAg阳性患者持续病毒学应答（28%）低于对照组（55.56%），差异有统计学意义（P＜0.05）。老年组HBeAg转阴率8（32%）与对照组HBeAg转阴率9（33.33%）相比，差异无统计学意义（P＞0.05）。抑郁、心电图改变、白细胞计数下降不良反应发生率高于对照组（P＜0.05）结论 聚乙二醇干扰素α-2a能够抑制 HBeAg阳性和 HBeAg阴性的老年乙肝患者体内乙型肝炎病毒（HBV）-DNA复制，且能致HBeAg阳性患者血清学转阴。对于HBeAg阴性老年患者更易获得持续病毒学应答。治疗同时密切关注不良反应，及时干预。 R512.6; R592 【文献标识码】 A 【DOI】 ? Peginterferon alpha-2a in treatment of elderly chronic hepatitis B: clinical analysis of 62 cases ZHOU Hong1, WU Shi-Min1, MA Wei2* (1Department of Clinical Laboratory, Wuhan Medical Treatment Center, Wuhan 430023, China; 2Central Laboratory, the First Hospital of Wuhan City, Wuhan 430022, China) 【Abstract】 Objective To evaluate the efficacy and safety of peginterferon alpha-2a for the elderly patients with chronic hepatitis B (CHB). Methods A total of 62 elderly CHB patients (age＞60 years) admitted in Wuhan Medical Treatment Center from April 2009 to April 2013 were recruited in this study and assigned into the elderly group. Another 65 CHB patients (age＜60years) admitted during the same period were subjected to the control group. All the groups received a subcutaneous injection of peginterferon alfa-2a at a dosage of 180 μg once per week for 48 consecutive weeks. Results The early virological responses of HBeAg-positive and HBeAg-negative patients were significantly lower in the elderly group (4% and 5.4%) than control group (25.92% and 21.05%), and so was the sustained virological response in HBeAg-negative patients (28% vs 55.56%, P＜0.05). The HBeAg seroconversion was 8 (32%) in the elderly group and was 9 (33.33%) in the control group, with no significant difference between them (P＞0.05). The incidence of main adverse effe