| Objective: Through the observation of long-acting interferon(Pegasys-Peg IFN-alpha-2a)and nucleotide analogues(entecavir)on chronic hepatitis B virus(CHB)in serum of patients with hepatitis B virus deoxyribonucleic acid(HBV DNA),hepatitis B surface antigen(HBs Ag),liver hardness(LSM)and the influence of clear advantages and disadvantages of two kinds of treatment method,provide more accurate basis for treatment and opportunity for combination therapy can be taken.Methods: Collected from January 2012 to December 2014 at the Second Hospital of Jilin University to receive outpatient and / or hospital treatment,the analysis of history and related laboratory tests clearly diagnosed with chronic hepatitis B virus infection in patients with no anti-viral treatment And 138 patients with CHB in line with antiviral therapy.The Pegasys group was given 180 ?g of Peg IFN-?-2a once a week,subcutaneously,and entecavir group was given entecavir 0.5 mg / d orally.for 24 months.The levels of HBV DNA,HBs Ag quantification,LSM values,and ALT were observed at 0,1,3,6,12,18,and 24 months after treatment with Pegasys and entecavir,and the levels of HBV DNA and HBs Ag were measured at different time points according to the monitoring indexes.The changes of liver hardness(LSM)and ALT normalization rate were measured.The monitoring indexes,calculation results and index correlations of each group were compared and analyzed.Results:(After 24 months of treatment): entecavir group,HBe Ag positive seroconversion rate was 85.7%,HBe Ag negative conversion rate was 97.8%,the overall negative rate was 93.9%;between HBe Ag positive and negative seroconversion rate between P <0.05;Pegasys group,HBe Ag positive seroconversion rate was 15.8%,HBe Ag negative conversion rate was 23.7%,total the negative rate was 21.1%;between HBe Ag positive and negative negative rate have different P <0.05;two kinds of drugs on the performance of the DNA,P<0.05,the difference was statistically significant.The correlation between serum HBV DNA and HBs Ag in the two groups was less than 0.01 in the first month,and the P value in the 3rd,6th and 12 th month of the entecavir group was greater than 0.05;the 18 th and 24 th Month P values were less than 0.05.The P value of the 3rd and 6th month of the Pegasys group was greater than 0.05;the P value of the 12 th,18th and 24 th month was less than 0.05.In the entecavir group,the HBs Ag negative rate was 1.5%(1/66).In this group,the initial level of HBs Ag was less than 100 ng · L-1 in 3 cases,1 case was negative;the initial level was 100 ng or more L-1 and less than 200 ng · L-1 patients in 4 cases,non negative patients;HBs Ag initial level greater than or equal to 200 ng · L-1 patients in 59 cases,non negative patients.In the Pegasys group,the HBs Ag negative rate was 10.5%(6/57).In this group,the initial level of HBs Ag was less than 100 ng · L-1 in 6 cases,5 cases were negative;the initial level was 100 ng or more L-1 and less than 200 ng · L-1 patients in 5 cases,1case was negative;HBs Ag initial level greater than or equal to 200 ng · L-1 patients in 46 cases,non negative patients.There was a statistically significant difference between the two groups(P <0.05)by comparing the efficacy of the two drugs in the surface antigen(negative rate)of CHB patients.After the first,third,sixth,12 th and 18 th month of treatment,the two drugs to reduce the level of transaminase in patients with CHB,no difference between the two groups(P> 0.05),no statistically significant;at the 24 th month,There was a significant difference between the two groups(P <0.05).At the 12 th month,the algebraic rate of ALT in the entecavir group was 74.2%(49/66)and 70.2%(40/57)in the Pegasys group.Comparison between the two groups(P>0.05).The ALT normalization rate was 81.8%(54/66)at the 24 th month,Pegasys group was 64.9%(37/57),the difference between the two groups P <0.05,was statistically significant.The liver hardness values(LSM)of entecavir group and Pegasys group were compared with that of P<0.05 before treatment,the difference was statistically significant,the LSM value of the two groups after treatment was compared with that of P>0.05,the difference was not statistically significant.Conclusion: With the prolongation of treatment time,HBV DNA,HBs Ag,LSM and ALT levels in CHB patients showed a decreasing trend,HBV DNA negative rate,HBs Ag reduction level and negative rate and ALT normalization rate increased gradually,and Liver hardness was reversed and even returned to normal.For CHB patients,the efficacy of clearing HBV DNA in the entecavir group was significantly better than that in the Pegasys group.The efficacy of Pegasys group on HBs Ag was significantly better than that of nucleotides.There was a correlation between the negative rate of HBs Ag and the initial level in the Pegasys group.The lower the initial level before treatment,the better the results were obtained,but no significant correlation was found in the entecavir group.There was no difference between the two groups in comparing the efficacy of improving the degree of liver stiffness(LSM).The difference was not statistically significant.By drawing analysis,the LSM value of interferon treatment group showed a small increase trend after one month of treatment,and This condition was considered in relation to the patient's immune response after treatment but there was no occurrence of this phenomenon in the entecavir group.The entecavir group on the recovery rate of ALT was superior to Pegasys groupAfter 24 months of treatment,there was a significant correlation between HBV DNA and HBs Ag,that is,there was a significant positive correlation between the replication level of serum HBV DNA and HBs Ag quantification,and the overall direction was consistent. |
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