HBeAg阳性慢性乙型肝炎患儿应用聚乙二醇干扰素α-2a治疗的效果观察

李少雄; 符辉; 杨思谋; 庄太平

doi:10.3969/j.issn.1671-038X.2017.05.10

HBeAg阳性慢性乙型肝炎患儿应用聚乙二醇干扰素α-2a治疗的效果观察

- 1. 海南省陵水黎族自治县人民医院儿科, 海南陵水 572400;
- 2. 海南省陵水黎族自治县人民医院内科, 海南陵水 572400;
- 3. 海南省妇幼保健院儿科, 海南海口 570100

详细信息

作者简介:
李少雄,男,本科,主治医师,儿科专业,研究方向:呼吸系统疾病、消化系统疾病

通讯作者: 李少雄,E-mail:xuyajiehb@163.com

中图分类号: R575.1

收稿日期: 2016-11-09

The effect of polyethylene glycol interferon α-2a on the treatment of children with HBeAg-positive chronic hepatitis B

- 1. Department of Pediatrics, the People's Hospital of Lingshui, Hainan Lingshui 572400, China;
- 2. Department of Medicine, the People's Hospital of Lingshui, Hainan Lingshui 572400, China;
- 3. Department of Pediatrics, Maternal and Child Health Hospital of Hainan Province, Haikou 570100, China

More Information

Corresponding author: LI Shao-xiong, E-mail: xuyajiehb@163.com

Received Date: 09 November 2016

摘要

摘要: [目的]探究HBeAg阳性慢性乙型肝炎（CHB）患儿应用聚乙二醇干扰素（PEG-IFN）α-2a治疗的效果。[方法]选取60例于2013年4月~2015年4月入我院诊治的CHB患儿，年龄≤ 6岁患儿划为小龄组（32例），年龄>6岁划为大龄组（28例），采用PEG-IFNα-2a对患者进行治疗，视患者病情设定疗程（24~72周不等），分别在治疗前、治疗第4、12、24、52、72及治疗后第12、24周检测患者ALT、HBV DNA、HBV血清学标志物等指标，并在不同时间点对2组患者的生化学、病毒学、血清学应答进行对比。[结果]2组患者的生化学、病毒学应答在各时间点无明显差异，差异无统计学意义（P>0.05）；治疗第24周小龄组的HBsAg转阴率（40.63%）大于大龄组（7.14%），差异有统计学意义（χ²=7.23，P<0.01）；治疗第52周，小龄组和大龄组HBsAg定量水平分别降至（129.18±79.08） IU/ml和（229.55±54.17） IU/ml，和治疗前水平相比，前者降幅显著大于后者（P<0.05），治疗第72周，2组HBsAg定量水平继续下降至（51.77±31.49） IU/ml和（167.14±47.68） IU/ml，前者降幅显著高于后者（P<0.05）；2组的HBV DNA转阴率、HBeAg转阴率和血清学转换率、HBsAg清除率和血清学转换率在治疗第52周均有不同程度下降，但差异无统计学意义（P>0.05）。停药患儿随访期间病情无一复发。血象改变、轻度乏力、流感样症状是常见不良反应。[结论]CHB患儿应用PEG-IFNα-2a治疗的疗效与患儿年龄和疗程有关，患儿年龄越低，HBsAg定量水平下降越明显，HBsAg转阴率越高，疗程越长，疗效越明显。PEG-IFNα-2a是治疗小儿CHB的有效药物，治疗期间监测HBsAg定量水平对疗效有预测价值。
- HBeAg阳性慢性乙型肝炎 /
- 儿童 /
- 聚乙二醇干扰素α-2a /
- 疗效
Abstract: [Objective] To explore the effect of polyethylene glycol interferon α-2a on the treatment of children with HBeAg-positive chronic hepatitis B.[Methods] 60 patients with CHB from April 2013 to April 2015 were selected in our hospital.And all of them were divided into younger group(≤ 6 ages) and older group(>6 ages).And they were treated with PEG-IFNα-2a from 24 weeks to 72 weeks.And the results of HBV, DNA ALT, HBV serological markers and other indicators were tested before the treatment, 4 th, 12 th, 24 th, 52 th, 72 th week during the treatment, 12 th, 24 th weeks after treatment.[Results] There was no significant difference between the two groups in the biochemical and viral response at each time(P>0.05).The HBsAg negative rate of younger group (40.63%) was significantly higher than that of older group(7.14%) in 12 th weeks(χ²=7.23, P<0.01).The HBsAg level of the younger groups and older group were reduced to(129.18±79.08) IU/ml and(229.55±54.17) IU/ml in 52 th weeks.Compared with the former level, the reduction of the younger groups was significantly larger than the latter(P<0.05).And in 72 th weeks, the reduction of the younger groups[(51.77±31.49) IU/ml]still was significantly larger than the older group[(167.14±47.68) IU/ml](P<0.05).There was no significant difference in the results of HBV DNA negative rate, HBeAg negative rate and serological conversion rate, HBsAg removal rate and the seroconversion rate of the two groups in 52 th weeks(P>0.05).There was no recurrence of the patients who stopped using drugs during the follow-up period.The blood changes, fatigue, mild flu like symptoms were common adverse reactions.[Conclusion] The age and course of treatment are connected with the efficacy of IFN——2a-PEG.More prominent decrease in the HBsAg quantitative level and higher HBsAg clearance rate can be achieved in children of younger ages.Clinical efficacy can be improved with longer treatment.The change in HBsAg quantitative level has a predictive value for treatment outcome.Peg-IFNα-2a treatment is safe in children with CHB.
- HBeAg-positive chronic hepatitis B /
- children /
- interferon α-2a /
- treatment outcome

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