干扰素治疗肾综合征出血热的临床研究

Clinical Study of Interferon Therapy for Hemorrhagic Fever with Renal Syndrome

应用人白细胞干扰素α（ｈＩＦＮα）治疗肾综合征出血热（ＨＦＲＳ）２３例，基因工程干扰素α２ｂ（ｒＩＦＮα２ｂ）治疗ＨＦＲＳ２１例，均收到良好的疗效。与对照组相比，干扰素治疗组三痛消失较快，球结膜水肿消退较早，尿蛋白持续时间缩短，血尿素氮（ＢＵＮ）峰值减低，多尿期提前出现，血小板计数较快恢复正常，严重出血及继发感染等并发症明显减少，病毒膜蛋白（ＭＰ）和核蛋白（ＮＰ）在外周血单个核细胞（ＰＢＭＣ）中的表达迅速减弱，从小便排出的时间也明显缩短，血清抗－ＭＰ水平下降。结果提示，干扰素能抑制肾综合征出血热病毒（ＨＦＲＳＶ）在ＰＢＭＣ中复制和表达其结构蛋白。

Twenty three cases with hemorrhagic fever with renal syndrome (HFRS) were treated with hIFN α 1×10 6 u/d for 3 days(hIFN α group),and 21 cases treated with rIFN α2b 1.5×10 6 u/d for 3 days(rIFN α2b group). Comparing to control group, both hIFN α and rIFN α2b groups revealed desirable therapeutic effects. The sensation of headache, backache, orbitache and bulbar conjunctiva swelling relaxed faster, proteinuria lasted for a shorter time, the peak value of blood urea nitrogen (BUN) was lower, diuretic stage came out earlier, platelet count restored to normal quickly, severe hemorrhage and secondary infection and other complications reduced markedly, the expression of HFRS virus(HFRSV) membrane protein(MP) and nucleocapsid (NP) decreased rapidly in peripheral blood mononuclear cells (PBMC), the duration of MP and NP excretion in urine was much shorter, and serum anti MP antibody decreased to a lower level. These data suggest that the replication of HFRSV and the expression of the viral structural proteins in PBMC can be inhibited by interferon therapy, and the patient′s condition will be greatly improved.