干扰素治疗前后慢性乙型肝炎患者的血清学和组织学观察

Observation on serology and histology of patients with chronic hepatitis B after interferon treatment

目的 探讨干扰素治疗前后 ,慢性乙型肝炎患者的血清学和肝组织学变化。方法 于干扰素治疗前 1周内和治疗后 1周内 ,取 2 4例慢性乙型肝炎患者的血清和肝脏活检组织 ,检测其血清ALT、HBsAg、HBcAg、HBeAg、HBVDNA和金属蛋白酶组织抑制剂 1(TIMP 1) ,评价肝组织学活动指数 ,检测肝脏中的HBsAg、HBcAg、HBeAg、活化的肝脏星状细胞 (HSC)和TIMP 1。 结果 治疗后 ,9/ 2 4 (37.5 % )的患者发生了应答反应。与治疗前相比 ,干扰素治疗后慢性乙型肝炎患者血清中的HBVDNA明显下降 (P <0 .0 5 ) ,血清中的TIMP 1、肝脏的组织学活动指数 (HAI)、HBcAg、HBeAg、活化的HSC和TIMP 1均有明显下降 (P <0 .0 5 )。结论 干扰素治疗慢性乙型肝炎患者 ,可以抑制病毒复制 ,减少肝组织中病毒抗原表达 ,减少血清和肝组织中的TIMP 1,减少肝脏中活化的HSC数量。

Objective To investigate the changes in serology and liver histology of patients with chronic hepatitis B after interferon treatment. Methods Twenty four patients with chronic hepatitis B were enrolled in this research. Sera of patients were obtained before and after interferon treatment respectively. Liver biopsy was performed in each patient before and after treatment respectively. Serum ALT, HBsAg, HBcAg, HBeAg, HBV DNA and TIMP 1 were evaluated, as well as HAI(histological activity index), HBsAg, HBcAg, HBeAg, TIMP 1 and activated HSC in liver. Results The patients responded to interferon accounted for 7/24(37.5%). Compared with pretreatment, the serum HBV DNA and TIMP 1 decreased significantly( P <0.05) after treatment,so did the HAI, HBsAg, HBcAg, HBeAg, TIMP 1 and activated HSC( P <0.05) in liver. Conclusions Interferon treatment can inhibit viral replication in patients with chronic hepatitis B, decrease the viral antigen expression in liver, reduce the TIMP 1 in serum and liver, decrease the number of activated HSC in liver.