α干扰素对慢性丙型肝炎血清中HCV　RNA水平的影响

THERAPEUTIC EFFECT FOR CHRONIC HEPATITIS C AND QUANTITATIVE ANALYsls OF SERUM HCV RNA DURING INTERFERON ALFA TREATMENT

目的：了解ＨＣＶ不同基因型对α干扰素治疗的反应。方法：采取干扰素不同治疗量和不同疗程治疗病人。血清用逆转录酶一聚台酶链反应扩增ＨＣＶＲＮＡ５－非编码区，再用Ｓｌｏｔ－ｂｌｏｔ杂交鉴定。结果：ＨＣＶＲＮＡ阴转，丙氨酸转氨酶（ＡＬＴ）降至正常（完全反应）占４０．０％；３ｘ１０￣６Ｕ治疗一月无反应，增量６ｘ１０￣６Ｕ出现前述结果（部分反应Ｉ）占３６．７％：增量６ｘ１０￣６Ｕ治疗一月无反应，再增量９ｘ１０￣６Ｕ出现前述完全反应结果（部分反应Ⅱ）占１５．０％；增量９×１０￣６Ｕ治疗一月无反应（无反应）占８．３％。３８．６％ＨＣＶ基因１型、４４．４％Ⅱ型、４２．９％Ⅲ型是完全反应。２４例完全反应病人中１５例治疗前ＨＣＶＲＮＡ拷贝数低于１０／ｍｌ。结论：各基因型对于扰索的治疗反应无显著性差异，肝损害轻、血清ＨＣＶＲＮＡ拷贝数低者对干扰素治疗反应较好。

Aim: To observe the atnount of HCV-RNA(cDNA) and ALT in sera of 60 patients during alfa-inferferon therapy. Methods: Quaottitative PCR and hybridization (slot blot) techniques were used in this paper. Results: The results showed that a complete response(3MU,three times a week) was observed in 40% of all cases, partial response I (6MU, three times a week) was observed in 36.7%, partial respoctse Ⅱ (9MU, three times a week) in 15%, and non-response in 8.3% of cases. 62.5% complete responders whose HCV-RNA in sera before alfa-INF treatment were lower than 105 copies/ml, while 60% non-response cases had HCV-RNA more than 105 copies/ml. In complete responder group, 38.6% was HCV geatotype Ⅰ, 44.4% HCV genotype Ⅱ, and 42.9% genotype Ⅲ infections. Conclusion : When chronic active hepatitis and cirrhosis developed, the response to interferon therapy in general was worse than those in chronic persist- ent hepatitis and patients with 0-1 Knodell Score histological changes.