摘要
目的研究干扰素α治疗丙氨酸氨基转移酶(ALT)水平<2×正常值上限(ULN)的HBeAg阳性慢性乙型肝炎(CHB)患者的疗效以及预测因素。方法收集丙氨酸氨基转移酶轻度升高的HBeAg阳性的慢性乙型肝炎患者,予以短效干扰素α-1b治疗24周,随访24周,分析其基线血清HBV DNA载量及肝组织病理指标等与疗效的关系。结果共入组42例患者,48周时,有14例患者HBV DNA载量低于可测值,其中9例患者实现了HBeAg的阴转。基线HBV DNA<1×106拷贝/ml的患者,治疗后的HBV DNA阴转率高于基线HBV DNA≥1×106拷贝/ml的患者(55.6%vs 27.3%),但差异无统计学意义。肝组织炎症G2组疗效优于G1组(P<0.05);纤维化程度为S2～4组疗效优于S0～1组(P<0.05);肝组织HBcAg浆型+阴性分布组患者疗效优于核型+混合型分布组(P<0.05)。结论部分ALT轻度升高的HBeAg阳性慢性乙型肝炎患者干扰素治疗有效,基线HBV DNA低载量、活跃的肝组织炎症水平、较重的肝纤维化水平以及肝组织HBcAg浆型分布或者阴性可能是干扰素治疗有效的预测指标。
Objective To study the efficacy of interferon （IFN） -α in the treatment of chronic hepatitis B （CHB） patients with mild elevated alanine transaminase （ALT） （ALTO2×upper limit of normal or ULN） and positive HBe-antigen （HBeAg）. Methods Patients with ALT〈2 × ULN and positive HBeAg were re- cruited in the study and treated with INF-α-lb for 24 weeks and followed up for additional 24 weeks. Results A total of 42 patients were enrolled. At the end of the follow up, the serum HBV DNA in 14 patients and ser- um HBeAg in 9 patients turned negative. The HBV DNA negative conversion rate was higher in patients with HBV DNA 〈1.0×10^6 copies/ml than that with HBV DNA ≥1.0×10^6 copies/ml （55.6%vs 27.3%）. In terms of hepatic inflammation and histological fibrosis levels, the effieaey of INF treatment is better in G2 group than in G1 group patients （P〈0.05） and better in S2-4 group than in S0-1 group （P〈0.05）. The INF also showed better cure effect in patients with cytoplasmic distribution of HBcAg or negative HBcAg than pa- tients with nucleus and mixed distribution of HBcAg （P〈0.05）. Conclusions INF-α is effective in the treat- ment of CHB patients with mild elevated ALT. Low HBV DNA load, high inflammation level, severe fibrosis level and cytoplasmic distribution of HBcAg or negative HBcAg are factors affecting the efficacy of IFN in the treatment of this group of CHB patients.
出处
《中国病毒病杂志》
CAS
2013年第3期213-218,共6页
Chinese Journal of Viral Diseases
基金
深圳市科技计划项目(201103132)
