α_(1b)干扰素治疗小儿乙型肝炎病毒相关性肾炎的远期疗效

Long term effect of treatment in children HBV associated glomerulonephritis with human recombinant Interferon α_(1b)

鉴于皮质醇激素治疗小儿乙型肝炎病毒相关性肾炎(HBV-GN)的各种不良反应,现应用国产人 a_(1b)基因工程干扰素治疗8例小儿 HBV-GN,剂量为300万 U/m^2体表面积隔天肌注,4个月后改为每周肌注2次持续2个月,总疗程6个月,用药期间无严重副反应。结果是5例尿蛋白消失,肾病缓解,2例尿蛋白减少,1例无进步。6例血清总蛋白、白蛋白上升。有3例血清 HBV 抗原转阴(其中2例 HBeAg,HBsAg 均转阴,1例 HBeAg转阴,HBsAg 仍阳性),以上结果说明 a_(1b)干扰素治疗小儿 HBV-GN 有一定缓解率,故认为该药不失为治疗HBV-GN 的有效药物。

Glucocorticoid has been used as a con- ventional drug for treatment of nephrotic syndrome.However,various adverse effects have been observed,such as secondary in- fection,hypertensive encephalopathy,crisis of adrenal insufficiency etc.Particularly it could potentially enhance the virus replica- tion in vivo in case of HBV associated glomerulonephritis(HBV-GN).Therefore,it is important to find out a drug both safe and effective for treatment of HBV-GN. Human recombinant Interferon α_(1b) (rhIFNα_(1b))manufactured in Shanghai China has been used for treatment of 8 cases of children HBV-GN,at a dosage of 3×10~6u/ m^2 surface area by q.o.d intramuscular in- jection.Four months later,the treatment continued by b.i.w for another two months,with a overall course of 6 months. Regular examination of blood cell counts, liver and renal function assay,serological HBV markers and serum protein analysis by electrophoresis were performed.No severe side effects have been observed.It has been demonstrated that proteinuria disappearence and remission of nephrotic syndrome were observed in 5 cases,proteinuria decreased in 2 cases and no progress at all was observed in 1 case.Serum total protein and albumin increased in 6 cases.Concerning serological HBV markers,both HBeAg and HBsAg were converted to negative in 2 cases, HBeAg became negative but HBsAg re- mained positive in 1 case:These results indi- cated that rhIFNα_(1b) should be an effective drug of choice in treatment of children HBV-GN.