内科

目的评估延长聚乙二醇干扰素α-2a疗程对慢性乙型肝炎患者疗效及安全性的影响。方法40例HBeAg阳性慢性乙型肝炎患者均接受聚乙二醇干扰素α-2a治疗，其中常规治疗组（20例）患者治疗48周，延长治疗组（20例）患者治疗72周。所有患者治疗结束后随访48周。观察治疗结束时及治疗结束后随访24、48周时两组患者的HBsAg清除率、HBeAg血清学转换率、HBV-DNA阴转及ALT复常情况。观察两组患者治疗全程中所有不良反应发生情况。结果治疗结束后随访24、48周时，延长疗程组患者的HBeAg血清学转换率均高于常规疗程组（P＜0.05），延长疗程组患者的HBV-DNA阴转率也明显高于常规治疗组（P＜0.05）。延长疗程具有和标准疗程相同的安全性。结论相对于标准疗程，延长治疗疗程使HBeAg阳性的CHB患者在治疗结束后维持了相对持久的病毒学应答，延长疗程可能是提高临床疗效的一种有希望的治疗策略。

ObjectiveTo evaluate the efficacy and safety of extended durations of PEG-IFNa-2a monotherapy in treatment of patients with chronic hepatitis B. Methods40 patients with chronic hepatitis B were divided into extended therapy group (72 weeks treatment) and standard therapy group(48 weeks treatment), both group were treated with peginterferonA-2a monotherapy and were followed up until 48 weeks post-treatment. Serum ALT, HBsAg clearance, HBeAg seroconversion and HBV-DNA levels of the two groups were determined at baseline, the end of treatment, and at 24 and 48 weeks post-treatment. All adverse reactions in treatment duration were observed. ResultsAt 24 and 48 weeks post-treatment, the rate of HBeAg seroconversion in the extended therapy group was significantly higher than that in the standard therapy group(P＜0.05), HBV-DNA negativity rate in the extended therapy group was also significantly higher than that in the standard therapy group(P＜0.05). Extended therapy group had the same safety as standard therapy group. ConclusionsCompare with standard therapy, extended durations of PEG-IFNa-2a may be a promising strategy to improved clinical efficacy which safely achieved higher rates of sustainable HBeAg seroconversion and HBV-DNA suppression in patients with HBeAg-positive CHB than.