香菇多糖对阿德福韦酯治疗慢性乙型肝炎疗效的影响

Effect of lentinan on the therapeutic effect of chronic hepatitis B patients treated with adefovir

摘要:

目的观察香菇多糖对阿德福韦酯（ADV）治疗慢性乙型肝炎疗效的影响。方法将符合条件的慢性乙型肝炎患者随机分为香菇多糖和ADV联合治疗组（34例）、ADV单一治疗组（32例），均治疗12个月，观察两组血清丙氨酸转氨酶（ALT）复常率、乙型肝炎e 抗原（HBeAg）阴转率、HBeAg/抗HBe血清转换率、乙型肝炎病毒（HBV） DNA下降水平及不良反应。结果治疗6个月和12个月，联合治疗组的HBeAg阴转率分别为35.48%、61.29%，显著高于单一治疗组的10.34%、34.48%（分别χ2=5.29，P=0.02；χ2=4.31，P= 0.04）；治疗12个月，联合治疗组HBeAg/抗 HBe血清转换率为48.39%，高于单一治疗组的24.14%（χ2=3.79，P=0.05）。治疗1个月、3个月和6个月的ALT复常率，联合治疗组分别为54.84%、67.74%、77.42%，显著高于单一治疗组的24.14%、41.38%、51.72%（分别χ2=5.88，P=0.02；χ2=4.21，P=0.04；χ2=4.35，P=0.04）。治疗1个月、3个月和6个月的HBV DNA阴转率，联合治疗组分别为41.94%、61.29%、70.97%，显著高于单一治疗组的13.79%、34.48%、44.83%（分别χ2=5.84，P=0.02；χ2=4.31，P=0.04；χ2=4.21，P=0.04）。两组患者均无明显不良反应。结论香菇多糖可增强ADV治疗慢性乙型肝炎的短期疗效，尤其是可提高HBeAg阴转率和HBeAg/抗HBe血清学转换率；ADV可有效降低HBV DNA复制。

Abstract:

ObjectiveTo investigate the effect of lentinan on the therapeutic effect of chronic hepatitis B patients treated with adefovir (ADV).MethodsSixtysix patients with chronic hepatitis B were randomly divided into  lentinan plus ADV treatment (34 cases) and only ADV  treatment (32 cases) groups, all patients received treatment  for 12 months. Patients’ normalization of the alanine aminotransferase(ALT), negative conversion rate of   HBeAg, HBeAg/antiHBeAg seroconversion rate, serum HBV DNA decreasing levels and side effect were observed. ResultsAt 6 and 12 month of treatment, negative seroconversion rate of HBeAg in combination treatment group was 35.48% and 61.29% respectively, which was significantly higher than 10.34% and 34.48% of single treatment group (χ2=5.29, P=0.02; χ2=4.31, P=0.04, respectively); At 12 month of treatment, HBeAg/antiHBeAg seroconversion rate  in combination treatment group was 48.39%, which was significantly higher than 24.14% of single treatment group (χ2=3.79, P=0.05). At 1,3,6 month of treatment, normalization of ALT in combination group was 54.84%, 67.74% and 77.42% respectively, which was significantly higher than 24.14%, 41.38% and 51.72% of single treatment group (χ2=5.88, P=0.02; χ2=4.21, P=0.04; χ2=4.35, P=0.04 respectively).  At 1,3,6 month of treatment , serum HBV DNA negative conversion rate in combination group was 41.94%, 61.29% and 70.97% respectively, which was significantly higher than 13.79%, 34.48 and 44.83% of single treatment group(χ2=5.84, P=0.02; χ2=4.31, P=0.04; χ2=4.21, P=0.04, respectively). Both groups had no side effect. ConclusionLentinan can  enhance the shortterm therapeutic effect of chronic hepatitis B patients treated with ADV，especially the negative conversion rate of HBeAg and HBeAg/antiHBeAg seroconversion rate; ADV can efficiently decrease the replication levels of HBV DNA.