不同剂量干扰素治疗慢性乙型肝炎时血清2′,5′-寡腺苷酸合成酶活性的变化

Changes of Serum 2', 5'-Oligoadenylate Synthetase Activity during Different Doses Interferon Treatment for Chronic Hepatitis B

目的:观察不同剂量干扰素治疗慢性乙型病毒性肝炎时血清2′,5′-寡腺苷酸合成酶(2′,5′-OAS)的变化,了解细胞抗病毒状态建立与乙肝病毒复制的关系。方法:32例慢性乙肝患者随机分为3蛆,即1MU干扰素腹腔注射11例(治疗Ⅰ组),3MU干扰素皮下注射11例(治疗Ⅱ组),分别连续注射5天,以后每周3次,共16周,并与不用干扰素治疗的10例(对照组)作对比,通过2′,5′-OAS、ALT、HBeAg、HBV-DNA(PCR法)连续检测,评价治疗反应。结果:疗程结束时,两治疗组和对照组ALT均下降,3组差异无显著性(P>0.05)。治疗Ⅰ组和治疗Ⅱ组2′,5′-OAS的活性均增加,治疗Ⅰ组在疗程结束时达峰值,治疗Ⅱ组在疗程早期就明显升高,而对照组无升高(P<0.05)。2′,5′-OAS的增幅水平与HBeAg、HBV-DNA的阴转呈相关性。结论,2′,5′-OAS可能是监测干扰素治疗慢性乙型肝炎疗效的有效指标。

Aim:To observe the changes of serum 2', 5'-oligoadenylate synthetase (2', 5'-OAS) activity in patients with chronic hepatitis B when different doses interferon (IFN) were used, and to comprehend the relation between antiviral state established in cells and replication of hepatitis B virus. Methods: 32 patients with chronic hepatitis B were assigned randomly to three groups. Treatment group Ⅰ consisting of 11 patients received 1 megaunit (MU) IFN by ab-dominocentesis daily for 5 days, and then three times weekly for 16 weeks. Treatment group Ⅱ consisting of 11 patients, too, received 3 MU IFN by subcutaneous injection daily for 5 days, and then three times weekly for 16 weeks. control group (10 cases) received no IFN treatment. Response was predefined as loss of HBeAg, HBV-DNA (PCR) and changes of serum alanine amino-transferase (ALT). 2', 5'-OAS was evaluated as potential predictors of response to therapy. Results: The ALT levels in both treatment groups and control group decreased at the end of course of treatment. There were no significant difference in three groups (P>0. 05). 2', 5'-OAS activities increased in both treatment groups, but not in the control group (P<0. 05). There were changes of different curves of 2', 5'-OAS in treatment group Ⅰ and Ⅱ. The peak of 2', 5'-OAS activity was found at the end of therapy of group Ⅰ , and the early stage of therapy of gropuⅡ. 2', 5'-OAS levels were correlated with returned negative of HBV-DNA and HBeAg. Conclusion: This study suggests that 2', 5'-OAS may be a useful marker to monitor IFN efficacy during treatment and to predict the clinical respose.