慢性丙型肝炎患者干扰素治疗前后血清自身抗体变化的临床观察

Changes of Serum Autoantibodies in Patients with Chronic Hepatitis C before and after Interferon Treatment

目的探讨慢性丙型肝炎患者干扰素治疗前后血清自身抗体的合并状况。方法回顾性分析2005年2月-2008年2月66例慢性丙型肝炎患者应用干扰素治疗前后的检测结果,观察治疗前后自身抗体合并状况及与干扰素疗效的关系。结果①66例慢性丙型肝炎患者中39例自身抗体阳性,阳性率59.1%(39/66),主要为ANA;②自身抗体的产生与年龄相关,而与性别、HCVRNA定量无关;③自身抗体阳性组干扰素应答率66.7%(26/39)明显高于阴性组40.7%(11/27),二者比较差异有统计学意义;④干扰素治疗后,自身抗体阴性组自身抗体检出率为44.4%(12/27),但滴度均<1∶320;治疗前抗甲状腺球蛋白抗体阳性患者会出现较高的甲状腺功能异常率。结论慢性丙型肝炎合并血清自身抗体阳性的患者干扰素应答率高于阴性组,但应注意抗甲状腺球蛋白抗体,以预测不良反应。

Objective To explore the consolidation of serum autoantibodies in chronic hepatitis C patients treated with interferon.Methods The clinical data of 66patients with chronic hepatitis C treated with interferon from February 2005to February 2008were retrospectively analyzed.The relationship between the consolidation of serum autoantibodies and the effect of interferon was observed.Results ① There were 39 patients with positive autoantibodies;the positive rate was 59.1% （39/66）and ANA was the main antibody.②The appearance of autoantibodies correlated with the patients′ages but not with the sexes and CVRNA quantification.③The interferon response rate in autoantibodies positive group was 66.7% （26/39）which was much higher than that in the negative group;the difference between the two groups was significant.④After the interferon treatment,the autoantibody detection rate in autoantibody negative group was 44.4%（12/27）and the titer was lower than 1：320;before the treatment,the anti-thyroglobulin antibody-positive patients had a higher rate of thyroid dysfunction.Conclusions The interferon response rate in chronic hepatitis C patients with positive serum autoantibodies is higher than that in the patients with negative serum autoantibodies.Anti-thyroglobulin antibodies should be noted to predict the adverse effects.