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目的:探讨干扰素alpha（interferon alpha，IFNα）联合核苷类（NA）抗病毒药物治疗儿童慢性乙型肝炎（chronic hepatitis B，CHB）的疗效及影响因素。方法:收集95例1~6岁HBeAg阳性肝组织学活检确诊CHB患儿的临床资料，其中IFNα单药治疗组（32例），IFNα+LAM联合治疗组（63例），根据48周疗效分为HBsAg转阴组和未转阴组。结果:治疗48周、96周HBeAg转阴率分别为50.5%和70.5%，HBsAg转阴率分别为34.7%和50.5%。多因素Logistic回归分析显示，年龄、性别（男）、基线HBsAg水平是48周HBsAg转归的独立影响因素（n P<0.05）。治疗12周、24周和36周的血清HBsAg水平对48周疗效预测价值较高，AUC均大于0.8，敏感度和特异度均超过70%；治疗36周时的B细胞计数预测效果较好，AUC为0.975，敏感度为69.2%，特异度为85.2%。n 结论:1~6岁HBeAg阳性CHB患儿应用IFNα可获得较好疗效，低龄、低HBsAg水平以及女性是HBsAg转阴的预测因素。CHB患儿外周血淋巴细胞亚群的检测有助于判断预后。“,”Objective:To investigate the efficiency and influencing factors of combined therapy with interferon alpha (IFNα) and nucleotide analogues (NA) antiviral drug in the treatment of chronic hepatitis B (CHB) in children.Methods:Clincial data of 95 1-6 years old children diagnosed as CHB by liver biopsy were collected, including IFNα monotherapy group (n=32) and combined therapy of IFNα and lamivudine (LAM) group (n=63). The patients were classified into HbsAg negative group and non-HbSAg negative group according to the therapeutic results at 48 weeks.Results:After 48 weeks and 96 weeks of antiviral treatment, the HbeAg negative rates were 50.5% and 70.5%, respectively while HBsAg negative rates were 34.7% and 50.5%, respectively. Multivariate logistic regression analysis showed that age, gender (male) and baseline HBsAg level were the independant influencing factors for HBsAg negative after 48 weeks of treatment (n P<0.05). HBsAg levels at 12, 24 and 36 weeks had high predictive values for the treatment results at 48 weeks. The AUC values were all higher than 0.8 while all the sensitivities and specificities exceeded 70%. The B lymphocytes count at 36 weeks of treatment showed high value of prediction with AUC of 0.975 and sensitivity and specificity as 69.2% and 85.2%, respectively.n Conclusions:IFNα was effective in HBeAg-positive CHB children aged 1-6 years old. Young age, low HBsAg level and female were predictors of HBsAg negative. The detection of peripheral blood lymphocyte subsets in CHB children can be helpful to judge the prognosis.