陆星羽,刘敬磊,黄心芮,张萌萌,陈立艳

目的：比较既往IFN-α经治与初治的HBeAg阴性慢性乙型肝炎（CHB）患者再次使用聚乙二醇干扰素α-2b（PEG-IFN-α-2b）的疗效差异。方法：回顾性纳入HBsAg＜10000 IU/ml且HBeAg阴性的CHB患者50例，分为初治组（26例）和再治组（24例），分析两组基线及治疗过程中HBsAg、HBV DNA的变化。结果：初治组基线HBsAg中位数（1115.78 IU/ml）及HBV DNA（3.93±1.18 log₁₀IU/ml）均显著高于再治组（156.10 IU/ml，P=0.0072；2.83±1.02 log₁₀IU/ml，P=0.0213）。治疗12周及24周时，两组HBsAg下降值、下降百分比及HBV DNA下降值均无统计学差异。结论：既往IFN-α治疗的HBeAg阴性CHB患者在停药后仍可维持长期免疫控制及病毒学应答，其再次使用PEG-IFN-α-2b的疗效与初治患者相当，且安全性良好，不良反应可控，耐受性高。

慢性乙型病毒性肝炎；乙肝表面抗原；聚乙二醇干扰素

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