聚乙二醇干扰素α-2a治疗HBeAg阳性慢性乙型肝炎

Treatment of Peginterferon alfa-2a on Patients with Chronic Hepatitis B

目的:观察聚乙二醇干扰素α-2a(PEG-INFα-2a)治疗慢性乙型肝炎(CHB)前后患者的肝组织病理变化。方法:对符合条件的12例CHB患者使用PEG-INFα-2a 180μg,sc,1次/周,连用48周,分别于治疗前及停药后第24周行肝穿,对治疗前后的肝活检组织分别进行炎症和纤维化分级计分,统计学分析。结果:治疗后肝组织炎症和坏死记分较治疗前降低,点状融合坏死治疗前后统计学差异显著(P<0.05)。组织病变活动性(HAI)积分、汇管区周围坏死、和汇管区炎症积分,均较治疗前有明显下降,但差异无显著性,而治疗后的纤维化积分则未见明显下降。结论:PEG-INFα-2a能有效改善慢性乙型肝炎病人的肝组织学状况,但对已经发生纤维化的肝组织未见明显改善。

Objective： To compare the pathological changes in the liver before and after the treatment of the patients with hepatitis B with peginterferon alfa-2a. Method： 12 patients were given peginterferon alfa-2a 180μg sc 1/w. The treatment lasted 48 weeks. A biopsy was done before the treatment and in the 24th week after it, respectively. The inflammation and fibrosis changes of the liver were evaluated and statistically analyzed. Result： The scores of the inflammation and necrosis have reduced, compared with those of the pretreatment. The focal necrosis had a marked change in the treatment with peginterferon alfa-2a（ P 〈 0.05 ）. No change was observed in the fibrosis. The patients with serum viral response had a marked change in the periportal necrosis, focal necrosis and portal inflammation. No change was observed in its fibrosis, either. Conclusion： The histological liver condition can be improved with peginterferon alfa-2a but no significant improvement was observed in the existing changed fibrosis.