干扰素治疗丙型肝炎疗效相关因素分析

CORRELATIVE FACTOR ANALYSIS OF HEPATITIS C TREATED WITH INTERFERON

目的：探讨预测干扰素治疗慢性丙型肝炎（ＣＨＣ）疗效的临床上适用、简便、易行的指标。方法：对采用干扰素（ＩＦＮα－１ｂ）治疗３２例ＣＨＣ临床资料进行观察，包括治疗前后肝功能（ＡＬＴ、ＳＢ、ＧＧＴ）、抗－ＨＣＶＯＤ水平、ＨＣＶ基因型、ＨＣＶＲＮＡ、ＳＩＬ－２Ｒ、β２－ＭＧ等，治疗结束时有效者为肝功能复常同时ＨＣＶＲＮＡ阴转，其余反应模式均为无效者。结果：ＨＣＶ基因型为Ⅲ型患者疗效（５／１０）明显高于Ⅱ型（２／１９）（Ｐ＜０．０５），有效者治疗前血清抗—ＨＣＶＯＤ明显低于无效者（Ｐ＜０．０５），治疗后有效者β２－ＭＧ升高水平（３．４５±１．０８）ｍｇ／Ｌ明显高于无效者（１．３３±０．９５）ｍｇ／Ｌ（Ｐ＜０．０５），而两者治疗前ＡＬＴ、ＳＢ、ＧＧＴ、ＩｇＭ、β２－ＭＧ患者的年龄无明显差别（Ｐ＞０．０５）。结论：感染ＨＣＶ基因型，治疗前抗—ＨＣＶＯＤ水平及治疗后β２－ＭＧ变化对预测ＩＦＮ治疗ＣＨＣ疗效有一定参考价值。

Objective:To find clinical suitable,simple and feasible parameters to predict the effect of chronic hepatitis C(CHC) treated with interferon-1b(IFN).Methods:Pre-therapy and post-therapy,some parameters of 32 CHC patients treated with IFN were observed,including their liver functions (ALT,SB,GGT),Anti-HCV OD values,HCV genotypes HCV RNA,SIL-2R,β 2-MG,etc.In the end of therapy,the patients with normal ALT and negative HCV RNA were called responders,others were called non-responders.Results:Respondent rate was higher in HCV Ⅲ(5/10) than in HCV Ⅱ (2/19) (P<0.05);pre-therapy Anti-HCV OD value was lower in responders than in non-responders (P<0.05);post-therapy,elevated values of β 2-MG in responders (3.45±1.08) mg/L were higher than in non-responders (1.33±0.95) mg/L(P<0.05).No significant difference was found in age,the values of ALT,SB,GGT,IgM,β 2-MG pre-therapy (P<0.05).Conclusion:Some parameters such as HCV genotype,pre-therapy Anti-HCV OD value and elevated value of β 2-MG may be useful to predict the effect of CHC treated with IFN.