摘要
目的观察儿童慢性乙型肝炎(CHB)应用α-干扰素(IFN-α)治疗引起的抗纤维化效应。方法30例小儿CHB应用IFN-α治疗24周以上,且停药后随访36周,其中5例治疗前后均行肝活体组织检查。所有患儿均在治疗前、治疗后24周和36周,应用放射免疫法检测患儿血清肝纤维化标志物:透明质酸(HA)、层连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)。结果应用IFN-α治疗前(0周)、治疗后24周和36周,小儿CHB血清肝纤维化标志物HA值分别为(243.6±70.5)ng/mL、(145.2±51.6)ng/mL、(85.1±40.3)ng/mL;LN值分别为(180.5±61.3)ng/mL、(102.7±40.6)ng/mL、(62.8±32.6)ng/mL;Ⅳ-C值分别为(137.1±48.6)ng/mL、(108.9±40.3)ng/mL、(70.5±30.7)ng/mL,治疗后血清肝纤维化标志物较治疗前显著下降(P<0.05)。肝活体组织病理检查显示,治疗后肝组织纤维化分期比治疗前有明显降低(P<0.01)。结论IFN-α在治疗小儿CHB时,不仅有抗病毒作用,在改善肝纤维化方面,也具有一定疗效。
Objective To investigate the clinical effect of IFN-α for treatment of hepatic fibrosis in children with chronic hepatitis B. Method Thirty CHB children were given IFN-α orally for twenty-four weeks. Before treatment and 24 and 36 weeks after the treatment,serum levels of hyaluronie acid （ HA）, laminin （LN） and type Ⅳ collagen （Ⅳ-C） of the patients were measured by radioimmunoassay and their liver biopsy specimens were also assessed. Results Before treatment and 24 and 36 weeks after the IFN-α treatment ,serum levels of HA were （243. 6±70. 5 ）ng/mL , （145. 2±51. 6 ）ng/mL and （85. 1±40.3）ng/mL respectively;serum levels of LN were （ 180. 5±61. 3 ） ng/mL , （ 102. 7 ± 40. 6 ） ng/mL; （62.8±32.6）ng/mL respectively, Ⅳ-C levels were（ 137.1 ± 48.6 ） ng/mL, （ 108. 9 ± 40.3 ） ng/mL, and （70.5 ±30. 7 ）ng/mL respectively. There was a significant reduction （P〈0.05） in these serum values after the treatments. Histopathologieal examinations of the liver biopsies showed that the degree of hepatic fibrosis obviously declined by one or two degrees after the treatment （P〈0.01）. Conclusions IFN-α not only has effect in anti-virus treatment,but also has effect in treating hepatic fibrosis.
