血清HBV DNA和丙氨酸氨基转移酶水平与干扰素-α1b治疗慢性乙型肝炎疗效的关系

Prediction of serum HBV DNA and alanine aminotransferase levels on efficacy of interferon alfa-1b in treatment of patients with chronic hepatitis B

目的探讨血清HBV DNA定量和丙氨酸氨基转移酶(ALT)水平与干扰素-α1b治疗慢性乙型肝炎疗效之间的关系。方法86例慢性乙型肝炎患者接受干扰素-α1b治疗48周。结果在治疗结束时,完全应答组患者治疗前血清HBV DNA水平为5.8±0.4log copies/ml,显著低于部分应答组(6.9±1.2log copies/ml)和无应答组(7.7±1.4log copies/ml,P<0.05);在完全应答患者,血清HBV DNA水平于治疗第4和第12周时较治疗前下降大于2log;完全应答组患者治疗前血清ALT水平(175.3±39.2IU/L)高于部分应答组(115.4±22.3IU/L)和无应答组(88.4±21.2IU/L),有显著性差异(P<0.05);治疗4周时,完全应答组血清ALT水平较治疗前上升(185.2±35.20IU/L),明显高于部分应答组(89.5±15.7IU/L)和无应答组(75.6±18.4IU/L),差异显著(P<0.01)。结论慢性乙型肝炎患者在接受干扰素-α1b治疗前和治疗开始后4周至12周时,血清HBV DNA水平低和ALT水平高预示疗效较好。

Objective To evaluate the correlation between the efficacy of interferon-α1b and the serum HBV DNA ＆ alanine aminotransferase（ALT） levels in chronic hepatitis B patients. Methods 86 patients with chronic hepatitis B were treated with interferon-α1b for 48 weeks. Results Before treatment,serum HBV DNA were lower in complete responders（5.8±0.4 log copies/ml） compared with partial responders（6.9±1.2 log copies/ml） and non-responders（7.7±1.4 log copies/ml）,respectively （P〈0.05）. A significant decline of serum HBV DNA was seen after interferon-α1b administration after 4 weeks to 12 weeks in complete responders;Compared with partial responders （115.4±22.3 IU/L） or non-responders （88.4±21.2 IU/L）,serum ALT in complete responders （175.3±39.2 IU/L） was higher before treatment （P〈0.05） and serum ALT in complete responders increased after 4 weeks of treatment. Conclusion Serum HBV DNA and ALT level at the baseline and after treatment for 4 weeks to 12 weeks are good predictors for interferan-α1b efficacy.