聚乙二醇干扰素α-2a治疗HBeAg阳性慢性乙型肝炎患儿的疗效观察
目的研究聚乙二醇干扰素(PEG-IFN)α-2a治疗HBe Ag阳性的慢性乙型肝炎(CHB)患儿的疗效。方法随机入组的来自昆明市第三人民医院31例2~16岁儿童CHB患儿,按年龄分为小龄组(2~6岁,n=17)及大龄组(7~16岁,n=14)。所有患儿均接受PEG-IFNα-2a治疗(首剂104μg/m2,1次/周,逐渐增加剂量至135μg/周),疗程24~72周不等。研究过程中监测ALT、HBV DNA、HBV血清学标志物及HBs Ag定量水平等指标,比较两年龄组在不同时间点的生化学、病毒学、血清学应答,分析疗效与年龄、疗程及治疗过程中HBs Ag定量水平动态变化的关系及安全性。计量资料组间...
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Published in | 临床肝胆病杂志 Vol. 31; no. 2; pp. 193 - 197 |
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Main Author | |
Format | Journal Article |
Language | Chinese |
Published |
昆明市第三人民医院肝三科,昆明,650041
2015
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Subjects | |
Online Access | Get full text |
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Summary: | 目的研究聚乙二醇干扰素(PEG-IFN)α-2a治疗HBe Ag阳性的慢性乙型肝炎(CHB)患儿的疗效。方法随机入组的来自昆明市第三人民医院31例2~16岁儿童CHB患儿,按年龄分为小龄组(2~6岁,n=17)及大龄组(7~16岁,n=14)。所有患儿均接受PEG-IFNα-2a治疗(首剂104μg/m2,1次/周,逐渐增加剂量至135μg/周),疗程24~72周不等。研究过程中监测ALT、HBV DNA、HBV血清学标志物及HBs Ag定量水平等指标,比较两年龄组在不同时间点的生化学、病毒学、血清学应答,分析疗效与年龄、疗程及治疗过程中HBs Ag定量水平动态变化的关系及安全性。计量资料组间比较采用t检验,计数资料比较采用χ^2检验。结果小龄组与大龄组各时间点的生化学、病毒学应答方面差异均无统计学意义(P值均〉0.05)。治疗24周时小龄组的HBs Ag阴转率明显高于大龄组(41.2%vs 7.1%;χ^2=4.644,P〈0.05);治疗52及72周时小龄组的HBs Ag定量水平分别为129.22±78.99和51.80±31.54 IU/ml;大龄组患儿52及72周HBs Ag定量水平分别为4677.12±2557.85和1031.37±546.37 IU/ml,与基线相比小龄组患儿52及72周HBs Ag定量水平下降幅度显著高于大龄组,差异有统计学意义(t值分别为2.25、2.23,P值均〈0.05)。治疗52周,小龄组与大龄组HBV DNA阴转率、HBe Ag阴转率、HBe Ag血清学转换率、HBs Ag清除率与血清学转换率均有增加的趋势,但差异均无统计学意义(P值均〉0.05)。延长治疗至72周的患儿HBV DNA阴转率100%,HBe Ag血清学转换率为80%,HBs Ag血清学转换率为60%。25例停药随访的患儿均无复发。研究中常见的不良反应为流感样症状、血象改变、食欲下降。治疗前后身高、体质量与同龄儿童差异无统计学意义。结论对于小儿CHB而言,PEG-IFNα-2a是可选治疗方案,PEG-IFNα-2a的疗效与患儿年龄和疗程有关。年龄越小,HBs Ag定量水平下降幅度越大,HBs Ag阴转率越高;延长疗程可提高疗效。治疗过程中HBs Ag定量水平变化具有预测疗效的价值。儿童应用安全性较好。 |
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Bibliography: | LIU Yunhua, LI Zhen, LIU Li, et al. ( Third Department of Liver Diseases, The Third People's Hospital of Kunming, Kunming 650041, China) Objective To investigate the clinical efficacy of pegylated interferon α - 2a ( PEG - IFNα - 2a) in the treatment of children with HBeAg -positive chronic hepatitis B (CHB). Methods A total of 31 children with CHB aged from 2 - 16 years were randomly en- rolled in this study and divided into two groups based on the age : younger group ( age 2 - 6 years, n = 17 ) and older group ( age 7 - 16 years, n = 14). All patients were administered PEG- IFNα- 2a at the initial dose of 104 μg/m^2/week, which gradually increased to 135 μg/week. The course of treatment ranged from 24 to 72 weeks. The indices including alanine aminotransferase ( ALT), hepatitis B virus (HBV) DNA, HBV serological markers, and HBsAg quantitative level were assayed at baseline and then regularly throughout the course of treatment. Treatment responses including biochemical, virological, and serological responses |
ISSN: | 1001-5256 |
DOI: | 10.3969/j.issn.1001-5256.2015.02.012 |