慢性乙肝患者干扰素治疗前后肝组织学变化的观察

Liver tissue inflammation activity grading,fibrosis staging and immunohistochemistry observation in chronic hepatitis Bpatients before and after interferon treatment

目的:探讨干扰素α治疗慢性乙型肝炎患者的肝组织学变化。方法:对照组:常规护肝治疗1年,治疗组:隔日肌内注射重组人干扰素α-2b 500～600万U,疗程1年,基础治疗同对照组。结果:治疗组中25例(占83.3%)炎症活动分级明显减轻,对照组中3例(占20%)炎症活动有改善,差异有显著性(P<0.01);治疗组21例(占70%)患者肝组织纤维化明显改善,对照组中1例(7.3%)差异有显著性(P<0.01)。治疗组治疗前后肝组织内HBsAg、HBcAg的半定量计分分别为(2.33±1.28)、(1.85±0.67)(P<0.01)及(1.83±1.68)、(0.38±0.88)(P<0.01),HBcAg转阴12例。与对照组[治疗前后肝组织内HBsAg、HBcAg的半定量计分分别为(1.93±0.88)、(2.4±0.91),(1.27±1.59)、(1.63±1.68)]比较均差异有显著性(P<0.01)。结论:干扰素能明显改善肝组织的炎症及纤维化,明显减少肝组织内HBsAg、HBcAg的表达。

Objective：To study the histdogical changes of liver in chronic hepatitis （CHB） patients after interferon 2 treatment and compare their results with those in control group.Methods：The control group was treated with routine protective liver treatment for 1 year ;besides the basic treatment as control group,the treatment group was added with recombinant human interferon 2-2b 5-6 million units intramuscular injection every other day,the course of treatment was also 1 year.The regular pathological and immunohistochemistrical examinations in two groups were performed by liver biopsy before and after treatment and their liver infllammation activity grading,fibrosis staging and the changes of HBsAg and HBcAg level were compared.Results：After treatment, the inflammation activity grading in 25 cases （83.5%） abated obviously in treatment group,while 3cases （20%） in control group with a significant difference between them（P〈0.01）;the fibrasis in 21-cases （70%） improved obviously in treatment group,while only one case in control group With a significant difference between them （P〈O.01）.The half-quantified score of HBsAg and HBcAg was 1.93±0.88,2.4±0.91 and 1.27±1.59,1.63±1.68 respectively in the control group before and after treatment and 2.33±1.28,1.85±0.67 and 1.83±1.68,0.38±0.88 respectively in treatment group,in which 12cases got negative with a significant difference between them（P〈0.01）. Conclusion：Interferon can obviously improve the liver tissue inflammation activity and fibrosis, and decrease the expressions of HBsAg and HBcAg.