重组干扰素的α-2b治疗慢性活动性乙型病毒性肝炎的疗效观察

A controlled study of recombinant interferon alfa-2b with or without prednisone withdrawal in the treatment of chronic active hepatitis B

应用重组干扰素α-2b对20例慢性活动性乙型病毒性肝炎患者进行了临床对照研究。治疗组10例采用IntronA5mu,每周3次,皮下注射,疗程12周、其中8例治疗前应用短程皮质激素撤除疗法。对照组10例采用常规护肝药物。在随访1年时,治疗组8例症状消失,ALT持续正常水平,2例各有一次复发,症状再现,ALT升高,85.7％(6/7)HBeAg血清转换为抗HBe,30％(3/10)HBV-DNA阴转。对照组仅5例临床症状消失,ALT持续正常水平或基本正常,5例出现9次复发,症状再现,ALT升高,28.6％(2/7)HBeAg自发阴转,但无1例抗-HBe阳转,10％(1/10)HBV-DNA阴转。重组干扰素治疗期间副反应均可耐受,且呈可逆性改变。结果提示应用短程皮质激意撤除疗法与重组干扰素联合治疗方案是目前治疗我国慢性活动性乙型病毒性肝炎的最有效方法。

Twenty patients with chronic active hepatitis B were studied in a controlled trial. Ten cases were assigned to receive 5mu interferon alfa-2b (Intron A* )subcutaneously three times per week for 12 weeks. Eight of 10 patients in the interferon group were treated with prior prednisone withdrawal. The other 10 patients served as control with common treatment. At the end of 1 year's follow up 8(80%) of 10 treated patients and 5(50%) of 10 controls continued to have normal serum alanine aminotransferase levels. The other 2 treat edpatients and 5 controls had two and nine relapses, respectively. Six (85. 7%) of 7 treated patients with positive serum HBeAg showed seroconversion to anti-HBe compared with 0 of 7 controls(P<0. 01).Three (30%) of 10 treated patients turned to be HBV-DNA negative by PCR compared with 1(10%) of 10 controls, but this difference was not statistically significant (P = 0. 32). These results indicate that interferon alfa-2b therapy following withdrawal of prednisone is benificial in reducing the disease activity in chronic active hepatitis B.