目的：通过Meta分析评价聚乙二醇干扰素（PEG-IFN a-2a）和恩替卡韦（ETV）对中国HBeAg阳性慢性乙型病毒性肝炎（CHB）患者的疗效。方法计算机检索MEDLINE和3个主要的中文数据库。由两名评价员对纳入的有关PEG-IFN a-2a联合ETV，ETV和PEG-IFN a-2a治疗中国HBeAg阳性CHB患者的随机对照试验独立进行评价。结果9个随机对照试验符合最终的纳入条件。Meta分析结果显示：在中国HBeAg阳性CHB患者中，PEG-IFN a-2a联合ETV组的丙氨酸转氨酶（ALT）复常率、HBV DNA阴转率、HBeAg血清转换率、HBeAg血浆清除率明显优于ETV组和PEG-IFN a-2a组，差异有统计学意义（P<0.05），但总体的HBeAg血清转换率和HBeAg血浆清除率较低。结论 PEG-IFN a-2a联合ETV组对中国HBeAg阳性CHB患者疗效较ETV组、PEG-IFN a-2a组显著，可作为治疗中国HBeAg阳性CHB的优先选择。%Objective To conduct a meta-analysis to determine the efficacy of peg the combination of PEG-IFN a-2a and ETV therapy versus PEG-IFN a-2a and entecavir(ETV)for HBeAg-positive chronic hepatitis B patients in China.Methods MEDLINE database and 3 main Chinese biomedical databases was retrieved.Two reviewers independently screened all reports to identify randomized controlled trials that evaluated the combination of PEG-IFN a-2a and ETV therapy for the treatment of HBeAg-positive chronic hepatitis B in China. Results Nine trials met the eligibility criteria for this Meta analysis.The combination of PEG-IFN a-2a and ETV therapy was more effective than PEG-IFN a-2a and ETV therapy in achieving ALT normalization,serum HBV DNA clearance,HBeAg seroconversion and serum HBeAg clearance in Chinese hepatitis B patients(P<0.05), but the seroconversion rate was low. Conclusion Treatment with the combination of PEG-IFN a-2a is more effective than PEG-IFN a-2a and ETV therapy,and can be prescribed as first-line treatment options for HBeAg-positive chronic hepatitis B patients in China.
展开▼
