摘要
目的探讨聚乙二醇干扰素（IFN）α-2a联合病毒唑治疗自身免疫抗体阳性慢性丙型肝炎的临床疗效。方法慢性丙型肝炎患者93例，筛查自身免疫抗体；然后分为试验组（自身免疫抗体阳性）和对照组（自身免疫抗体阴性），均给予聚乙二醇IFNα-2a联合病毒唑治疗。观察治疗前丙型肝炎病毒（HCV）RNA载量和肝功能、治疗过程中血丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）水平变化以及病毒学应答情况。结果93例慢性丙型肝炎患者中，共检出自身免疫抗体阳性28例，其中抗线粒体抗体阳性17例，抗平滑肌抗体阳性8例，1型抗肝肾微粒体抗体阳性3例。两组治疗前HCVRNA载量，以及治疗后快速和持续病毒学应答率比较差异均无统计学意义（P〉0．05）。治疗前及治疗中试验组患者血ALT和AST水平均高于对照组，但仅治疗第36，48周两组比较差异有统计学意义（P〈0．05）。结论聚乙二醇IFNα-2a联合病毒唑可有效治疗自身免疫抗体阳性和阴性慢性丙型肝炎患者；但自身免疫抗体阳性的患者肝功能恢复情况不如自身免疫抗体阴性患者效果好。
Objective To research the clinical curative effect of pegylated interferon α-2a （Peg-IFNα-2a） combined with ribavirin in treating chronic hepatitis C with positive autoantibodies. Methods The autoantibodies were screened in 93 cases of chronic hepatitis C patients and then the patients were divided into positive group and negative group. Both of the two groups were given therapy with Peg-IFNα-2a combined with ribavirin. The capacity of hepatitis C virus （HCV） RNA, virological response rate, and blood concentration of alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were quantified before and in the process Of treatment. Results Twenty-eight patients had autoantibodies, with 17 patients of antimitochondrial antibody, 8 patients of anti smooth muscle antibody and 3 patients of anti-liver-kidney microsomal antibody-1. The quantity of HCV RNA and the virological response rate had no significant difference before and after treatment （P 〉 0.05 ）. The concentration of ALT and AST in positive group were higher than those in negative group before and in the process of treatment, while there were obvious differences only after 36 weeks of treatment （P 〈 0.05 ）. Conclusion Peg-IFNα -2a combined with ribavirin is effective for chronic hepatitis C for all the patients, but liver function of autoantibody negative patients have a better recovery.
出处
《中国医师进修杂志》
2014年第25期32-34,共3页
Chinese Journal of Postgraduates of Medicine
基金
国家自然科学基金（30571642）
