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国产干扰素 |
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赵春惠 郎振为 许德军 金荣华 徐瑞平
摘要 目的 观察干扰素α-2b治疗慢性乙型肝炎(HBeAg 阳性或阴性)的组织学及血清HBV DNA的变化。方法 22例病人治疗前、治疗结束1周内行肝穿刺活检。肝组织损伤程度按Knode11计分法，免疫组织化学检测肝组织中HBsAg、HBcAg表达。治疗前、治疗结束及治疗后随访18周，双盲定量测定HBV DNA，同时检测HBsAg、HBcAg及血清生化改变。结果 治疗结束时肝组织学中坏死及炎症程度与治疗前相比明显减轻(P＜0.01)；55%(12/22)病人肝组织学活动指数得以改善。肝组织中HBcAg转阴11例。门脉炎症及纤维化程度无明显改善(P＞0.05)。无论HBeAg阳性或阴性，HBV DNA水平较治疗前明显下降(P＜0.01)。治疗结束HBeAg阴转率为42.9%。HBeAg阳性与HBeAg阴性患者相比，其肝组织学损伤程度的改善及血清HBV DNA的下降无明显区别。结论 干扰素α-2b治疗慢性乙型肝炎(HBeAg阳性或阴性)，可明显降低血清HBV DNA的水平，并明显改善其肝组织学的炎症及坏死程度。
关键词 慢性乙型肝炎 干扰素α-2b 组织学 HBV DNA
Response to interferon alpha-2b in patient with e-antigen
negative and positive chronic hepatitis B
Zhao Chunhui，Lang Zhenwei，Xu Dejun
(Beijing You An Hospital, Beijing 100054)
Abstract Objective To investigate the liver histological changes and serum HBV DNA changes induced by interferon α-2b or therapy for 18 weeks in patients with e-antigen positive or negative chronic hepatitis B infection. Methods Twenty two patients were enrolled in this study. All patients had a liver biopsy within a week before starting interferon therapy. Interferon α-2b was given at a dose of 3Mu thrice a week for 18 weeks. A second liver biopsy was taken for comparison at the end of week 18.Blinded biopsies were scored according to Knode11's histology activity index (HAI), and HBsAg and HBcAg were examined with immunohistochemistry method. The serum samples corresponding with liver biopsies were collected and HBV DNA,e-antigen, s-antigen and biochemical markers were measured, Results Histological assessment revealed a significant improvement in intralobular inflammation and periportal +/-bridging necrosis after treatment(P＜0.01).Fifty-five percent (12/22)patients had a reduction of hepatic necroinflammatory HAI score by≥2 points at the end of 18 weeks of interferon α-2b therapy compared to pre-treatment values. HBcAg disappearance from liver tissues was seen[1] [2] [3] 下一页
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