干扰素α-2b对慢性乙型肝炎患者氧化损伤状态的影响

Oxidative stress in patients with chronic hepatitis B before and after interferon alpha-2b treatment

目的 探讨不同基因型慢性乙型肝炎患者干扰素α-2b（IFN α-2b）治疗前后氧化损伤状态的变化及其与抗病毒疗效的关系。方法 35例符合干扰素治疗指征的慢性乙型肝炎患者，分别给予IFN α-2b300万u，肌内注射，每周3次，疗程12周。治疗前后化学比色法测定患者血清丙二醛和总抗氧化能力指标的变化，同时在治疗过程中定期复查患者肝功、胆红素、血常规、HBV DNA及病毒标志物的变化，核酸杂交-酶联免疫吸附法测定乙肝病毒基因分型，18例健康人作为正常对照。结果 慢性乙型肝炎患者血清丙二醛浓度明显高于健康对照组（P〈0．05），总抗氧化能力明显低于健康对照组（P〈0．05）。不同基因型患者血清丙二醛水平及总抗氧化能力无显著差别（P〉0．05）。干扰素治疗后患者血清丙二醛水平明显低于治疗前水平（P〈0．05），无效组治疗后的丙二醛浓度仍高于健康对照（P〈0．05）。干扰素治疗前有效组的血清总抗氧化能力明显高于无效组（P〈0．05），治疗后血清总抗氧化能力明显升高（P〈0．05）。结论 IFN α-2b治疗可以明显改善慢性乙型肝炎患者的氧化-抗氧化损伤平衡障碍，抗病毒治疗中适当应用抗氧化剂可能有助于提高临床疗效。

Objective To investigate the impacts of interferon alpha-2b （IFN α-2b） on the oxidative stress states in the treatment of chronic hepatitis B （CHB） with different genotypas. Methods Thirty-five patients with chronic hepatitis B and 18 healthy volunteers as a control were enrolled in this present study. In control and patients group, the serum alanine aminotransferase （ALT） and aspartate aminotransferase （AST）, serum malondialdehyde （ MDA ） levels, surum total antioxidative stress capacity （ TAC ） were measured spactrophotometrically. After the therapy with interferon alpha-2b at the dose of 300 million units via intramuscular injection thrice a week for 12 weeks, these parameters were measured again in the patient group. The genotypes of hepatitis B virus were detected by polymerase chain reaction and hybridization. The effective group was defined as the patients with complete response and partial response. Results The elevated concentrations of MDA and impaired levels of TAC in the patients with CHB were observed as compared to the healthy controls （ P 〈0.05 for both） .There were no significant differences in serum levels of MDA and TAC in CHB patients with various genotypes （ P 〉 0.05）. The serum levels of MDA after the treatment with IFN α-2b were significantly lower than the pretreatment levels （P 〈 0.05 ）, which even returned to the normal concentration （P 〉 0.05 ） in the effective group. There were significant increases in the TAC after the IFN α-2b therapy in the effective group. Howerer, the significant differences in the TAC levels before and after the INFα-2b treatment were not observed in the nonresponsive group. Conclusion The oxidative stress could be improved with IFN α-2b treatment of chronic hepatitis B patients. The results suggest that antioxidant treatment for chronic hepatitis B patients may help improve the effect of anti-virus therapy.