摘要
瞄准:为了有希望地评估, 4 选择了浆液纤维变性标记(tenascin, hyaluronan,骨胶原 VI, TIMP-1 ) 以前,在期间并且在有长期的肝炎 B 的孩子的 IFN 治疗以后的 12 瞬间。方法:有长期的肝炎 B 的 47 个连续病人(范围 4-16 年,平均数 8 年) 经历了 IFN 治疗(为 20 wk 的 3 亩 tiw ) 。纤维变性舞台和发炎等级以前以一种使失明的方式被估计并且在治疗的结束以后的 12 瞬间。浆液纤维变性标记用自动化试金被决定。结果:IFN 治疗改进了组织学的发炎但是没在整个组或在亚群改变纤维变性。仅仅 hyaluronan 与组织学的纤维变性显著地相关(r = 0.3383, P = 0.021 ) 。基础纤维变性标记没在应答者(42.5%) 之间并且非不同应答者(57.5%) 。在 IFN 治疗期间,仅仅浆液 tenascin 在整个组并且在显著地减少了非应答者。预告的处理价值什么时候与相比,在治疗以后珍视 12 瞬间, TIMP-1 在所有病人并且在增加了非,应答者,和 hyaluronan 在所有病人并且在应答者减少了。结论:Tenascin 反映与长期的肝炎 B 在孩子的 IFN 治疗期间减少的肝的纤维发生和发炎。TIMP-1 相互关联与非有组织学的纤维变性的反应和 hyaluronan。
To evaluate prospectively 4 selected serum fibrosis markers (tenascin, hyaluronan, collagen Ⅵ, TIMP-1) before, during and 12 mo after IFN treatment of children with chronic hepatitis B. METHODS: Forty-seven consecutive patients with chronic hepatitis B (range 4-16 years, mean 8 years) underwent IFN treatment (3 MU tiw for 20 wk). Fibrosis stage and inflammation grade were assessed in a blinded fashion before and 12 mo after end of treatment. Serum fibrosis markers were determined using automated assays.RESULTS: IFN treatment improved histological inflammation but did not change fibrosis in the whole group or in subgroups. Only hyaluronan correlated significantly with histological fibrosis(r = 0.3383, P = 0.022). Basal fibrosis markers did not differ between responders (42.5%) and nonresponders(57.5%). During IFN treatment only serum tenascin decreased significantly in the whole group and in nonresponders. When pretreatment values were compared to values 12 mo after therapy, TIMP-1 increased in all patients and in nonresponders, and hyaluronan decreased in all patients and in responders.CONCLUSION: Tenascin reflects hepatic fibrogenesis and inflammation which decreases during IFN treatment of children with chronic hepatitis B. TIMP-1 correlates with nonresponse and hyaluronan with histological fibrosis.
基金
Supported by the Interdisciplinary Center for Clinical Research(IZKF) of the University of Erlangen-Nuernberg, Germany
关键词
肝纤维化
血清标记物
儿童
乙型病毒肝炎
Biopsy
Collagen Ⅵ
Fibrogenesis
Fibrosis
Hepatitis B virus
Hyaluronan
Serum marker
Tenascin
TIMP-1