免疫疗法联合干扰素治疗慢性乙型肝炎的初步研究

A preliminary study on immunotherapy combined with interferon for chronic hepatitis B(CHB)

探讨免疫疗法联合干扰素治疗不同免疫应答期慢性HBV感染患者的疗效。 14 5例慢性乙型肝炎患者(免疫耐受期 6 6例 ,免疫清除期 6 4例 ,残余整合期 15例 )随机分为联合治疗组 (乙肝疫苗 +胸腺肽 +绿脓杆菌菌毛+干扰素 ,其中免疫耐受期 4 2例 ,免疫清除期 4 6例。共 88例 )和对照组 (单用干扰素治疗 ,其中免疫耐受期 2 4例 ,免疫清除期 18例。共 4 2例 ) ,观察ALT及病毒标志物变化。治疗后 ,免疫清除期联合治疗组的ALT复常率、HBeAg、HBVDNA阴转率和HBeAg/抗 -HBe血清转换率均显著高于对照组 (P <0 0 5 )。免疫耐受期 ,治疗组HBeAg、HBVDNA阴转率和HBeAg/抗 -HBe转换率均明显高于对照组 (P <0 0 5 )。免疫疗法联合干扰素治疗慢性乙型肝炎 ,疗效明显优于单用干扰素治疗。

To investigate the efficacy of immunotherapy combined with interferons on chronic viral hepatitis B in different immune response phases and to investigate new methods for treating hepatitis B. 145 CHB patients (66 patients were in immune tolerance phase and 64 patients were in immune clearance phase and 15 patients were in immune residual integrated phase) was randomly divided into Immunotherapy group (Hepatitis B vaccine, Thymosin and pilus of P. aeruginosa combined with IFN-α 1b was used to treat 88 patients, in which 42 patients were in immune tolerance phase and 46 patients were in immune clearance phase) and contol (interferon monotherapy was used to treat 42 patients, 24 patients in immune tolerance phase and 18 patients in immune clearance phase). The change of ALT and viral markers were observed. At the end of treatment, as for patients in immune clearance phase, the rate of normal ALT, the change in negtive rate of HBeAg and HBV DNA, and the rate of change in HBeAg/anti-HBeAg in immunotherapy group were siginificantly higher than those in control. (P<0.05). As for patients in immune tolerance phase, the negtive rate of HBeAg and HBV DNA, the rate of change in HBeAg/anti-HBeAg in immunotherapy group were siginificantly higher than those in control (P<0.05). Compaired with interferon monotherapy, the immunotherapy combined with IFN-α 1b is more effective to treat CHB.