Combination Therapy with Pegylated Interferon alpha-2b and Adefovir Dipivoxil in HBeAg-positive Chronic Hepatitis B versus Interferon Alone: A Prospective, Randomized Study

Currently available monotherapies of oral nucleoside/nucleotide analogs or interferon are unable to achieve a sustained and effective response in most of patients with chronic hepatitis B（CHB）. The objective of the present study was to compare the efficacy and safety of pegylated interferon（Peg-IFN） alpha-2b plus adefovir dipivoxil combination therapy versus Peg-IFN alpha-2b alone. Sixty-one HBeAg-positive chronic hepatitis B patients were randomized to receive Peg-IFN alpha-2b alone（1.5 μg/kg once weekly） or Peg-IFN alpha-2b plus adefovir（10 mg daily） for up to 52 weeks. Efficacy and safety analyses were performed on all participants who received at least one dose of study medication. The rate of HBeAg seroconversion and undetectable HBV-DNA were evaluated after 52 weeks of therapy. At the end of treatment, 11 of 30（36.7%） patients receiving combination therapy achieved HBeAg seroconversion versus 8 of 31（25.8%） in the monotherapy group（P=0.36）. In contrast, the percentage of patients with undetectable serum HBV DNA was significantly higher in the combination group than in the monotherapy group（76.7% vs. 29.0%, P〈0.001）. Thyroid dysfunction was more frequent in the combination group than in the monotherapy group（P〈0.05）. In HBeAg-positive CHB, combination of Peg-IFN alpha-2b and adefovir for 52 weeks resulted, at the end of treatment, in a higher virological response but without significant impact on the rate of HBeAg seroconversion and possibly an adverse effect on thyroid function.

CHOP-like Regimen in Combination with Rituximab and Peginterferon Alpha-2b in Newly-diagnosed Diffuse Large B-cell Non-Hodgkin＇s Lymphoma： Experience in a Chinese Center

OBJECTIVE To evaluate the efficacy of rituximab combined with CHOP-like regimen with or without IFN in patients newly diagnosed diffuse large B-cell Non-Hodgkin＇s lymphoma （DLBCL）.METHODS From January 2003 to July 2008, 51 patients received CHOP-like chemotherapy （cyclophosphamide 750 mg/m2, epirubicin 80 mg/m2, vindesine 2.8 mg/m2 on day 1, and prednisolone 100 mg/day on day 1 to day 5）. Thirty-one patients received CHOPR-like treatment （rituximab 375 mg/m2 1 day before CHOP-like chemotherapy）. Twenty patients received CHOP-like regimen in combination with peginterferon （pegIFN） （1μg/kg on day 5） and rituximab （on day 6）.RESULTS -The CR （complete remission） rate in the CHOPR-like （with or without pegIFN） group and in the CHOP-like group was 78.4% and 45.1% （P = 0.005）, respectively. The estimated mean time of overall survival （OS） in the CHOPR-like group and CHOP- like group was 58.7 ± 2.8 and 36.4 ±3.4 months, respectively （P = 0.002）. The rates of CR and OR （overall remission） in CHOPR- like with IFN arm were 85.0% and 95.0%, and the rates of those in CHOPR-like without IFN arm were 74.2% and 87.0% （P 〉 0.05）. The estimated mean time of 4-year-PFS （progression- free survival） in CHOPR-like with IFN arm and in CHOPR-like without IFN arm was 62.9 ±3.0 months and 51.0 ± 4.6 months （P = 0.092）, respectively. In the CHOPR-like with IFN arm, no patient relapsed after achieving CR, while the estimated rate of 4-year- DFS （disease-free survival） in the patients who reached CR in the CHOPR-like without IFN arm was （63.4 ± 19.3）% （P = 0.061）. CONCLUSION Rituximab combined with CHOP-like chemotherapy improved the prognosis of DLBCL patients. The IFN may help to improve the quality and duration of response of DLBCL patients treated with rituximab and CHOP-like regimen.

聚乙二醇干扰素α-2b联合富马酸替诺福韦二吡呋酯片对乙型肝炎患者的治疗效果

目的探究乙型肝炎患者使用聚乙二醇干扰素α-2b、富马酸替诺福韦二吡呋酯片联合治疗的效果。方法选取2022年1—12月在莆田学院附属医院感染性疾病科治疗的乙型肝炎患者中200例为研究对象,随机分为对照组(100例,服用富马酸替诺福韦二吡呋酯片治疗)和观察组(100例,采用聚乙二醇干扰素α-2b联合富马酸替诺福韦二吡呋酯片治疗)。对比治疗前后两组肝功能、乙型肝炎病毒转阴率和炎症因子水平。结果检测两组肝功能状况,治疗后24周观察组天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、胆红素水平均低于对照组(均P<0.05)。治疗后6、12、18、24周观察组乙型肝炎病毒转阴率均高于对照组(均P<0.05)。治疗后24周,观察组白细胞介素-4、生长分化因子、干扰素诱导蛋白-10水平均低于对照组(均P<0.05)。结论乙型肝炎患者使用聚乙二醇干扰素α-2b、富马酸替诺福韦二吡呋酯片联合治疗,可以改善患者肝功能、提升乙型肝炎病毒转阴率,降低炎症因子水平,促进患者恢复。

聚乙二醇干扰素α-2b联合替诺福韦对乙型肝炎患者肝功能及安全性的影响

目的:探讨聚乙二醇干扰素α-2b联合替诺福韦对乙型肝炎患者肝功能及安全性的影响。方法:选取2018年10月—2020年8月南阳医学高等专科学校第一附属医院收治的96例乙型肝炎患者作为研究对象,采用乱数表法分为A组和B组,每组各48例。A组给予替诺福韦酯片治疗,B组在A组基础上加用聚乙二醇干扰素α-2b治疗。比较两组患者治疗前、后总胆红素(TBIL)、白蛋白(ALB)、天门冬氨酸氨基转移酶(AST)、谷丙转氨酶(ALT)、干扰素-γ(IFN-γ)、白介素-10(IL-10)、白介素-4(IL-4)和白介素-2(IL-2)水平。比较两组患者乙型肝炎病毒(HBV)-DNA转阴率、乙型肝炎e抗原(HBeAg)转阴率、转换率和ALT复常率。统计两组患者治疗有效率和不良反应发生率。结果:治疗后,B组总胆红素(TBIL)、天门冬氨酸氨基转移酶(AST)和谷丙转氨酶(ALT)水平均低于A组,两组患者白蛋白(ALB)均升高且B组升高幅度大于A组,差异有统计学意义(t=15.629、27.253、30.580、11.761,P<0.05);治疗后,两组患者酶联免疫吸附测定干扰素-γ(IFN-γ)和白介素-2(IL-2)均升高,且B组升高幅度大于A组,白介素-10(IL-10)和白介素-4(IL-4)均降低,且B组降低幅度大于A组,差异有统计学意义(t=20.777、7.614、24.624、1.609,P<0.05);B组HBV-DNA转阴率、ALT复常率、乙型肝炎e抗原(HBeAg)转阴率、HBeAg转换率均高于A组,差异有统计学意义(χ^(2)=4.381、4.800、4.019、4.909,P<0.05);B组治疗总有效率高于A组,差异有统计学意义(χ^(2)=4.360,P<0.05);两组患者不良反应发生率比较,差异无统计学意义(χ^(2)=0.079,P>0.05)。结论:聚乙二醇干扰素α-2b联合替诺福韦可有效改善患者肝功能,调节免疫功能且安全性较高。

补肾调经汤联合人重组干扰素-α-2b对子宫内膜异位症体液免疫、CA125、EMAb水平的影响

【目的】探析补肾调经汤(在《景岳全书》大营煎方的基础上加味而成)联合人重组干扰素-α-2b治疗子宫内膜异位症(endometriosis,EMs)疗效及其对体液免疫、血清糖类抗原125(carbohydrate antigen,CA125)、抗子宫内膜抗体(antiendometrial antibody,EMAb)水平的影响。【方法】将86例EMs肾虚血瘀证患者随机分为观察组和对照组,每组各43例。对照组单纯给予人重组干扰素-α-2b治疗,观察组给予补肾调经汤联合人重组干扰素-α-2b治疗,疗程为1个月。观察2组患者治疗前后体液免疫因子[免疫球蛋白A(immunoglobulin A,IgA)、补体3(complement 3,C3)、补体4(complement 4,C4)]、子宫内膜异位包块直径及病理相关因子(CA125、EMAb)水平的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)治疗1个月后,观察组的总有效率为97.67%(42/43),对照组为81.40%(35/43),组间比较(χ2检验),观察组的疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的血清IgA水平均较治疗前明显升高(P<0.05),血清C3、C4水平均较治疗前明显降低(P<0.05),且观察组对血清IgA水平的升高幅度及对血清C3、C4水平的降低幅度均明显优于对照组(P<0.01)。(3)治疗后,2组患者的血清CA125、EMAb水平及子宫内膜异位包块直径均较治疗前明显降低(P<0.05),且观察组对血清CA125、EMAb水平及子宫内膜异位包块直径的降低幅度均明显优于对照组(P<0.01)。(4)观察组的不良反应总发生率为6.98%(3/43),对照组为11.63%(5/43),组间比较,差异无统计学意义(P>0.05)。【结论】补肾调经汤联合人重组干扰素-α-2b治疗EMs肾虚血瘀证患者临床疗效显著,可有效改善患者体液免疫因子及血清CA125、EMAb水平,缩小子宫内膜异位包块,且具有较高的安全性。

重组人干扰素α2B凝胶辅助治疗宫颈环形电切术术后创面修复及阴道微生态的影响

目的:研究重组人干扰素 α2B 凝胶辅助治疗宫颈环形电切术术后创面修复及阴道微生态的影响.方法:以我院 2020 年 6 月至 2022 年 11 月收治的 118 例行宫颈环形电切术治疗的宫颈糜烂患者,随机分为对照组、联合组,各 59 例.对照组采用保妇康栓治疗,联合组采用重组人干扰素α2B凝胶辅助保妇康栓治疗.比较两组治疗36 d后相关指标变化情况;采用型微循环观察仪宫颈微循环指标,采用酶联免疫吸附法测定阴道灌洗液相关免疫炎症因子干扰素-γ(Interferon-γ,INF-γ)、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、Toll样受体2(Toll like receptor 2,TLR2)水平,采用放射免疫法测定分泌型免疫球蛋白(Secretory immunoglobulin,sIgA)水平,且进行比较;并记录术后并发症发生率.结果:与治疗前相比,两组阴道排液时间、阴道流血时间、创面愈合时间、血性白带消失时间均明显降低,其中联合组更为显著(P<0.05);与治疗前相比,两组毛细血管管径、微血管管径、局部血流灌注均明显升高,其中联合组更为显著(P<0.05);与治疗前相比,两组阴道灌洗液INF-γ水平均明显升高,TNF-α、TLR2、sIgA水平均明显降低,其中联合组更为显著(P<0.05);与治疗前相比,两组术后并发症总发生率均明显降低,其中联合组更为显著(P<0.05).结论:重组人干扰素α2B凝胶辅助治疗宫颈糜烂术后患者可有效缓解临床症状,改善阴道微循环,减轻炎症反应,且降低术后并发症.

富血小板血浆联合干扰素α2b治疗带状疱疹的临床效果及安全性

目的观察富血小板血浆(PRP)联合干扰素α2b治疗带状疱疹的临床效果及安全性。方法选取2022年7月—2024年4月赣州市南康区第一人民医院收治的带状疱疹患者98例,采用随机数字表法分为研究组和对照组,每组49例。对照组在常规干预基础上采用干扰素α2b治疗,研究组在对照组基础上采用PRP治疗,2组均治疗4周。比较2组治疗效果,治疗前后视觉模拟评分法(VAS)评分、血清炎性因子[C反应蛋白(CRP)、白介素-6(IL-6)、白介素-10(IL-10)]水平、疼痛介质[前列腺素E_(2)(PGE_(2))、单核细胞趋化蛋白-1(MCP-1)、5-羟色胺(5-HT)]水平,不良反应。结果研究组总有效率(93.88%)高于对照组(79.59%)(χ^(2)=4.346,P=0.037)。治疗4周后,2组VAS评分较治疗前下降,且研究组低于对照组(P<0.01);2组CRP、IL-6、PGE_(2)、MCP-1及5-HT水平较治疗前下降,IL-10水平较治疗前升高,且研究组低/高于对照组(P<0.01)。研究组不良反应总发生率(2.04%)与对照组不良反应总发生率(6.12%)比较无显著差异(χ^(2)=0.261,P=0.610)。结论PRP联合干扰素α2b治疗带状疱疹的效果较好,可有效减轻疼痛程度,缓解体内炎性反应,且安全性较高。

人干扰素α2b栓在宫颈炎伴高危型HPV感染患者治疗中的效果及预后研究

目的探讨人干扰素α2b栓在宫颈炎伴高危型HPV感染患者治疗中的效果及预后情况。方法选取南安市洪濑中心卫生院2021年1月至2022年12月收治的宫颈炎伴高危型HPV感染患者200例,随机数字表法分组,对照组以苯扎氯铵溶液治疗,观察组以人干扰素α2b栓治疗,对比临床疗效。结果相比于对照组,观察组治疗总有效率更高,发展为慢性宫颈炎率更低(均P<0.05)。观察组治疗后肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)与C反应蛋白(CRP)水平均低于对照组(均P<0.05)。观察组治疗后腰酸腰痛、下腹坠胀、白带增多与接触性出血等症状改善率均高于对照组(均P<0.05)。用药期间,两组的不良反应率差异对比,P>0.05。结论人干扰素α2b栓在宫颈炎伴高危型HPV感染患者治疗中,可提升患者的疾病治疗效果,促使患者疾病症状得到改善,减轻患者炎症反应,改善其疾病预后。

妇科千金胶囊联合重组人干扰素α2b凝胶对慢性宫颈炎合并HPV感染患者的疗效分析

目的探讨重组人干扰素α2b凝胶对慢性宫颈炎合并人乳头瘤病毒(HPV)感染患者的临床效果。方法选取2022年11月—2023年10月我院妇科门诊收治的204例HPV感染慢性宫颈炎患者为研究对象,按照随机数字表法将其分为对照组与观察组,各102例。对照组采用重组人干扰素α2b凝胶治疗,观察组在对照组基础上联合妇科千金胶囊治疗。对比两组患者的临床疗效、宫颈HPV病毒载量和转阴率、炎症细胞因子水平及阴道微生态平衡情况。结果观察组治疗总有效率为97.06%,高于对照组的85.29%,差异有统计学意义(P<0.05)。治疗后,观察组HPV病毒载量低于对照组,HPV转阴率高于对照组,组间差异有统计学意义(P<0.05);观察组白细胞介素-6、肿瘤坏死因子-α均高于对照组,干扰素-γ低于对照组,组间差异有统计学意义(P<0.05);观察组阴道分泌物pH值和Nugent评分均低于对照组,组间差异有统计学意义(P<0.05)。结论妇科千金胶囊联合重组人干扰素α2b凝胶治疗慢性宫颈炎合并HPV感染患者治愈率高,同时可调节患者阴道微生态和降低患者炎性因子表达,可促进患者HPV转阴,有利于促进患者恢复。

高频电刀宫颈环切术联合重组人干扰素α-2b栓治疗宫颈癌前病变的效果分析

目的探讨高频电刀宫颈环切术治疗宫颈癌前病变患者配合重组人干扰素α-2b栓的效果。方法选取200例宫颈癌前病变患者为研究对象,依据随机数字表法分为对照组和研究组,每组100例。对照组采取高频电刀宫颈环切术治疗,研究组在对照组基础上术后给予重组人干扰素α-2b栓治疗,比较两组治疗效果、高危型人乳头瘤病毒(HPV)病毒清除效果及生活质量。结果研究组治疗总有效率高于对照组(P<0.05);术前,两组HPV病毒载量及生活质量评分比较,差异均无统计学意义(P>0.05);术后,研究组HPV病毒载量低于对照组,生活质量评分高于对照组(P<0.05)。结论宫颈癌前病变患者采用高频电刀宫颈环切术联合术后重组人干扰素α-2b栓治疗效果较好,可促使症状消失,病灶缩小,提高HPV病毒清除效果,并改善患者的生活质量,值得临床推广与应用。

The Predictive Value of Baseline HBs Ag Level and Early Response for HBs Ag Loss in Patients with HBe Ag-positive Chronic Hepatitis B during Pegylated Interferon Alpha-2a Treatment

Objective To explore the predictive value of baseline HBs Ag level and early response for HBs Ag loss in patients with HBe Ag-positive chronic hepatitis B during pegylated interferon alpha-2a treatment. Methods A total of 121 patients with HBe Ag-positive chronic hepatitis B who achieved HBs Ag loss were enrolled; all patients were treated with PEG-IFNα-2a 180 μg/week. Serum HBV DNA and serological indicators （HBs Ag, anti-HBs, HBe Ag, and anti-HBe） were determined before and every 3 months during treatment. Results The median treatment time for HBs Ag loss was 84 weeks （7-273 weeks）, and 74.38% （90 cases） of the patients needed extended treatment （〉 48 weeks）. The correlation between baseline HBs Ag levels and the treatment time of HBs Ag loss was significant （B = 14.465, t = 2.342, P = 0.021）. Baseline HBs Ag levels together with the decline range of HBs Ag at 24 weeks significantly correlated with the treatment time of HBs Ag loss （B = 29.862, t = 4.890, P = 0.000 and B = 27.993, t = 27.993, P = 0.005）. Conclusion Baseline HBs Ag levels and extended therapy are critical steps toward HBs Ag loss. Baseline HBs Ag levels together with early response determined the treatment time of HBs Ag loss in patients with HBe Ag-positive chronic hepatitis B during pegylated interferon alpha-2a treatment.

Treatment of Hepatitis C with Pegylated Interferon Alpha-2a and Ribavirin:Experience from Benin

Background: Viral hepatitis C (HCV) is common in Benin. Untreated, it can be complicated by cirrhosis and hepatocarcinoma, which are sources of death. The objectives of this work were twofold: 1) to evaluate the effectiveness and safety of treatment with classic dual interferon pegylated alpha-2a (IFN) and ribavirin therapy in Benin, and 2) to present problems related to financial accessibility to this treatment. Methods: This was a cross-sectional, descriptive and analytical study, with a retrospective collection of data from November 1, 2010 to December 31, 2015 and prospective collection from January 1, 2016 to July 31, 2016 (7 months). We included all patients treated with IFN + ribavirin for hepatitis C at CNHU/HKM. Sustained virological response (SVR) was defined as undetectable viral load C 6 months after stopping treatment. Safety was appreciated by the search for clinical and hematological adverse effects. Results: One hundred and six patients were followed for HCV, of whom 58 (54.7%) undergoing treatment (26 under standard dual therapy and 32 under direct-acting antivirals). Of the 26 patients under-conventional dual therapy, 12 (46.1%) were genotype 1, 13 (50%) genotype 2 and one (3.9%) genotype 4. In conventional dual therapy, SVR was achieved in 15 (57.7%) patients, including the genotype 4 patient, 4 out of 12 (33.3%) genotype 1 patients, and 10 out of 13 (76.9%) for genotype 2 patients. The most common side effects with this treatment were severe asthenia (23 cases), flu-like symptoms (22 cases), weight loss (21 cases) and neutropenia (22 cases), anemia and thrombocytopenia (20 of 26 cases). The overall cost of treatment per patient was 11,800,624 FCFA for genotypes 1 and 4;and 7,835,048 FCFA for genotype 2. Conclusion: The treatment of HCV with IFN + ribavirin in Benin is effective for genotype 2. But its adverse effects are manifold and its cost is high. The switch to direct-acting antivirals (more effective, better tolerated and less expensive) was therefore necessary.

弥漫大B细胞淋巴瘤患者血浆IFN-γ、IL-2及外周血T淋巴细胞亚群、NK细胞与其临床分期的关系

目的探讨弥漫大B细胞淋巴瘤(DLBCL)患者血浆干扰素γ(IFN-γ)、白细胞介素-2(IL-2)水平及外周血T淋巴细胞亚群、自然杀伤(NK)细胞与临床分期的关系。方法纳入河南中医药大学第三附属医院2020年12月至2022年12月收治的DLBCL患者198例,根据临床分期分成Ⅰ期组(31例)、Ⅱ期组(56例)、Ⅲ期组(59例)、Ⅳ期组(52例)。比较4组血浆IFN-γ、IL-2及外周血CD3^(+)、CD3^(+)CD4^(+)T、CD3^(+)CD8^(+)T、NK细胞水平,分析各指标与DLBCL分期的相关性。结果Ⅲ期组、Ⅳ期组的血浆IFN-γ、IL-2水平低于Ⅰ期组、Ⅱ期组(P<0.05)。Ⅲ期组、Ⅳ期组外周血CD3^(+)、CD3^(+)CD4^(+)T、CD3^(+)CD8^(+)T、NK细胞水平低于Ⅰ期组、Ⅱ期组(P<0.05)。DLBCL患者IFN-γ、IL-2与CD3^(+)、CD3^(+)CD4^(+)T、CD3^(+)CD8^(+)T、NK细胞水平呈正相关(P<0.05)。DLBCL患者的血浆IFN-γ、IL-2及外周血CD3^(+)、CD3^(+)CD4^(+)T、CD3^(+)CD8^(+)T、NK细胞水平与临床分期呈负相关(P<0.05)。IFN-γ、IL-2、CD3^(+)、CD3^(+)CD4^(+)T、CD3^(+)CD8^(+)T、NK细胞水平增高是控制临床分期增高的保护因素(P<0.05)。结论DLBCL患者的临床分期与血浆IFN-γ、IL-2及外周血T淋巴细胞亚群、NK细胞水平相关,且血浆IFN-γ、IL-2水平与T淋巴细胞亚群、NK细胞存在相关性,上述指标有望对DLBCL进展风险进行预测。

重组人干扰素α-2b阴道泡腾胶囊联合乳酸菌阴道胶囊治疗宫颈高危型HPV感染的效果及对微生态环境相关免疫因子的影响

目的探讨对宫颈高危型人乳头瘤病毒(HPV)感染患者实施重组人干扰素α-2b阴道泡腾胶囊联合乳酸菌阴道胶囊治疗的效果及对微生态环境相关免疫因子的影响。方法选取300例宫颈高危型HPV感染患者,随机分为对照组与研究组,各150例。对照组采取重组人干扰素α-2b阴道泡腾胶囊治疗,研究组在对照组基础上联合乳酸菌阴道胶囊治疗。比较两组临床疗效及治疗前后微生态环境相关免疫因子[白细胞介素(IL)-4、IL-12与干扰素(IFN)-γ]水平。结果研究组治疗总有效率(80.67%)高于对照组(52.00%),差异有统计学意义(P<0.05)。治疗后,两组IL-4水平均降低,IL-12、IFN-γ水平均升高,且研究组IL-4水平低于对照组,IL-12、IFN-γ水平高于对照组,差异有统计学意义(P<0.05)。结论重组人干扰素α-2b阴道泡腾胶囊联合乳酸菌阴道胶囊治疗宫颈高危型HPV感染患者的效果显著,可改善微生态环境相关免疫因子水平。

人干扰素α2b ELISA配体结合分析检测方法的建立

目的:建立金黄地鼠血浆和组织重组人干扰素α2b定量ELISA检测法,用于药物研发检测。方法:采用双抗夹心法建立金黄地鼠血浆和组织重组人干扰素α2b含量检测方法,确定其检测范围,验证其选择性、精密度与准确度和稀释线性,并对样本稳定性进行研究。结果:建立的方法检测范围为0.50~16.00 ng/ml。选择性结果显示不同个体来源空白金黄地鼠组血浆和组织匀浆无差异,血浆质控样本准确度为78.62%~104.69%,批内精密度为0.69%~18.21%,批间精密度为6.71%~15.81%,总误差均<30%,稀释线性良好。稳定性样本在3种不同保存条件(冰上放置2 h;−80~−75℃放置4 d;反复冻融3循环)下稳定性较好,回收率均在±20%内。结论:成功建立了基于配体结合的人干扰素α2b ELISA检测法,该方法灵敏度高,重复性好,检测效率高,为新药研发提供了可靠的检测方法。

重组人干扰素α2b栓联合乳酸菌阴道胶囊对宫颈高危型HPV感染患者疗效及阴道微生态的影响

目的探讨重组人干扰素α2b栓联合乳酸菌阴道胶囊对宫颈高危型人乳头瘤病毒(HPV)感染患者临床疗效及阴道微生态的影响。方法选取80例宫颈高危型HPV感染患者,根据随机数字表法分为对照组与研究组,各40例。对照组采用重组人干扰素α2b栓治疗,研究组在对照组基础上联合乳酸菌阴道胶囊治疗。比较两组临床指标(HPV转阴率、炎症因子水平、阴道微生态)。结果研究组停药3个月、6个月的HPV转阴率分别为67.50%、97.50%,均高于对照组的32.50%、80.00%,差异具有统计学意义(P<0.05)。治疗前,两组白细胞介素-12(IL-12)、白细胞介素-4(IL-4)、干扰素-γ(IFN-γ)及肿瘤坏死因子-α(TNF-α)水平比较,差异无统计学意义(P>0.05);治疗后,研究组IL-12、IFN-γ水平高于对照组,IL-4、TNF-α水平低于对照组,差异具有统计学意义(P<0.05)。研究组pH、Nugent评分低于对照组,差异具有统计学意义(P<0.05)。结论宫颈高危型HPV感染患者采用重组人干扰素α2b栓联合乳酸菌阴道胶囊治疗,较单用重组人干扰素α2b栓治疗,可以更有效改善阴道微生态,值得临床推广。

蓝芩口服液联合干扰素α-2b对疱疹性咽峡炎患儿的疗效及对细胞免疫和炎症因子的影响

目的探讨疱疹性咽峡炎患儿联合使用蓝芩口服液、干扰素α-2b的疗效及对细胞免疫和炎症因子的影响。方法选择2019年3月至2023年7月在开封市儿童医院医治的疱疹性咽峡炎患儿进行前瞻性研究,取样82例。使用动态随机盲选法,分成联合组与对照组,各41例。治疗前、治疗7d,评估患儿的细胞免疫【免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)】、炎症因子【C反应蛋白(CRP)、白细胞介素-2(IL-2)、降钙素原(PCT)】、康复指标、治疗效果与用药后不良反应。结果组内数值相比,两组患儿治疗7d的IgG、IgM、IgA、IL-2均呈升高趋势,CRP、PCT均呈下降趋势;组间数据相比,联合组治疗7d的IL-2、IgG、IgM、IgA均更高,CRP、PCT更低,差异有统计学意义(P<0.05);与对照组的降温时间、咽峡部疼痛缓解时间、疱疹愈合时间、在院时间相比,联合组更短,差异有统计学意义(P<0.05);在治疗效果上,联合组总有效率(90.24%)比对照组(73.17%)高,差异有统计学意义(P<0.05);在不良反应上,联合组总发生率(7.32%)比对照组(12.19%)低,差异有统计学意义(P<0.05)。结论疱疹性咽峡炎患儿使用蓝芩口服液、干扰素α-2b联合用药方案,疗效显著,可调节患儿细胞免疫状态,抑制炎症因子活性,缩短患儿相关临床症状康复周期,还可降低患儿的药物反应。

Combination of "low-dose" ribavirin and interferon alfa-2a therapy followed by interferon alfa-2a monotherapy in chronic HCV-infected nonresponders and relapsers after interferon alfa-2a monotherapy

AIM To report on the efficacy, safety and tolerability of interferon alfa-2a combined with a "low dose" of ribavirin for relapsers and non responders to alpha interferon monotherapy.METHODS Thirty-four chronic hepatitis C virus-infected non-responders to interferon alfa2a monotherapy (a course of at least 3 months treatment) and 13 relapsers to interferon alfa 2a monotherapy (a dose of 3 to 6 million units three times per week for at least 20 weeks but not more than 18 months) were treated with the same dose of interferon alfa-2a used before (3 to 6 million units three times per week) and ribavirin (10 mg/ kg daily) for 6 months. In complete responders, interferon alfa-2a was administered for further 6 months at the same dose used before as monotherapy.RESULTS Seven (20.6%) of 34 non-responders stopped the combined therapy due to adverse events, including two patients with histological and clinical Child A cirrhosis. In 17/27 (63%)non-responders, the combined therapy was stopped after three months because of non-response. Ten of the 27 non-responders completed the 1;2-month treatment course. At a mean follow up of 28 months (16- 37 months)after the treatment, 4/10 (15%) previous non-responders still remained complete responders,All 13 previous relapsers completed the 12-month treatment course. At a mean follow up of 22months (9 - 36 months) after treatment, 6/13(46%) the previous relapsers were stillsustained complete responders.CONCLUSION Our treatment schedule of the combined therapy for 6 months of interferon alfa2a with a low dose of ribavirin (10 mg/kg/day)followed by 6 months of interferon alfa-2amonotherapy is able to induce a sustainedcomplete response rate in 15% of non-responders and 46% of relapsers with chronic hepatitis C virus-related liver diseases comparable to those obtained with the standarddoses of ribavirin 1000 - 1200 mg/day.Randomized prospective controlled trials using lower total amounts of ribavirin in combination with interferon should be performed.

重组人干扰素α-2b联合阿奇霉素对宫颈炎患者炎症反应及症状缓解时间的影响

目的探讨重组人干扰素α-2b联合阿奇霉素对宫颈炎患者炎症反应及症状缓解时间的影响.方法回顾性分析2021年8月—2022年9月本院收治的86例宫颈炎患者的临床资料,按治疗方法不同进行分组,采用阿奇霉素治疗的43例为对照组,采用重组人干扰素α-2b联合阿奇霉素治疗的43例为观察组.比较两组患者的炎性因子水平、症状缓解时间、生活质量及不良反应发生情况.结果治疗14d后,观察组的血清肿瘤坏死因子-α、血清白细胞介素-6、超敏C反应蛋白水平分别为(67.84±11.48)pg/L、(111.42±17.64)ng/L、(3.48±0.61)mg/L,均低于对照组的(85.36±15.02)pg/L、(155.92±21.37)ng/L、(7.05±1.94)mg/L,组间差异有统计学意义(P<0.05).治疗14d后,观察组的阴道排液时间、宫颈修复时间分别为(26.14±5.41)d、(7.11±2.18)d,均短于对照组的(36.82±7.63)d、(15.14±3.51)d,组间差异有统计学意义(P<0.05).治疗14d后,观察组的血管内皮生长因子水平为(18.02±3.51)μg/L,健康调查简表评分为(81.32±10.96)分,均高于对照组的(15.63±2.54)μg/L、(62.33±8.74)分,组间差异有统计学意义(P<0.05).两组的不良反应总发生率比较,差异无统计学意义(P>0.05).结论重组人干扰素α-2b联合阿奇霉素治疗宫颈炎的效果显著,能减轻患者体内炎症反应,改善其腹痛症状,加快宫颈修复.

Pegylated interferon α-2b up-regulates specific CD8+ T cells in patients with chronic hepatitis B

AIM:To investigate the effect of pegylated interferon (IFN) α-2b on specific CD8+ T lymphocytes in patients with chronic hepatitis B (CHB). METHODS:Twenty-one patients with CHB were treated with pegylated IFN α-2b. Periphery blood mononuclear cells were isolated from fresh heparinized blood by Ficoll-Hypaque density gradient centrifugation (density:1.077 g/L,Pharmingen) at weeks 0,4,8,12,and 24,respectively. Frequency of circulating hepatitis B virus (HBV) epitope-specific CD8 T cells was detected by flow cytometry. Cytokines were detected by cytometric bead assay. RESULTS:The frequency of circulating HBV core or env-specific CD8 T cells was higher (P < 0.05),the number of HBV core specific CD8 T cells was greater at week 24 (P < 0.05),the level of Th1-type cytokines [interleukin (IL)-12,tumor necrosis factor-α,and IFN-γ] was higher,while that of Th2-type cytokines (IL-4,IL-6,and IL-10) was lower in responders than in nonresponders (P < 0.05) after pegylated IFN α-2b treatment. The IL-6 level was correlated with HBV DNA (r = 0.597,P = 0.04),while the inducible protein-10 (IP-10) level was correlated with serum alanine aminotransferase (ALT) (r = 0.545,P = 0.005). The IP-10 level at week 8 after pegylated IFN α-2b treatment could predict the normalization of ALT in CHB patients (positive predict value = 56%,negative predict value = 92%). CONCLUSION:Pegylated IFN α-2b can enhance the immune response of CHB patients by increasing the frequency of HBV specific CD8+ T cells and regulating the Th1/Th2 cytokines.