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.

Expression of bcl-2 protein in chronic hepatitis C:Effect of interferon alpha 2b with ribavirin therapy

AIM: Mechanisms responsible for persistence of HCV infection and liver damage in chronic hepatitis C are not clear. Apoptosis is an important form of host immune response against viral infections. Anti-apoptotic protein bcl-2 expression on liver tissue as well as the influence of interferon alpha 2b (IFNa2b) and ribavirin (RBV) were analyzed in patients with chronic hepatitis C. METHODS: In 30 patients with chronic hepatitis C (responders - R and non-responders - NR) treated with IFNα2b+RBV, protein bcl-2 was determined in hepatocytes and in liver associated lymphocytes before and after the treatment. RESULTS: The treatment diminished bcl-2 protein accumulation in liver cells in_patients with hepatitis C (P<0.05). Before and after the therapy, we detected bcl-2 protein in R in 87±15% and 83±20% of hepatocytes and in 28±18% and 26±10% of liver-associated lymphocytes, respectively. In NR, the values before treatment decreased from 94±32% to 88±21% of hepatocytes and 39±29% to 28±12% of lymphocytes with bcl-2 expression. There was no statistical correlation between bcl-2 expression on liver tissue with inflammatory activity, fibrosis and biochemical parameters before and after the treatment. CONCLUSION: IFNα2b+RBV treatment, by bcl-2 protein expression decrease, enables apoptosis of hepatocytes and associated liver lymphocytes, which in turn eliminate hepatitis C viruses.

Treatment of Conjunctival Malignant Melanoma with Topical Interferon Alpha-2a

Conjunctival malignant melanoma (CMM) is a potentially lethal neoplasm with a high rate of recurrence. The modality of treatment includes a wide surgical excision, cryotherapy, topical mitomycin C and Interferon alpha 2b (INF α 2b). The aim of the study is to present the treatment of a case with CMM using topical Interferon alpha 2a. We present a 38-year-old female with diffuse bulbar dark pigmentation of the conjunctiva that arises from previously primary acquired melanosis (PAM). Biopsy resulted positive for CMM and further investigations were negative for any metastasis. Treatment with topical interferon alpha 2a was started immediately and after three months melanoma disappeared. One year after follow-up there was no sign of recurrence in regional lymph nodes or distant metastasis.

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.

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.

Study on pharmacodynamics of recombinant interferon α-2b suppository

Objective To investigate the antiviral activity of recombinant interferonα-2b suppository(IFNα-2b)in vivo and in vitro.Methods The cytopathic-effect inhibition assay was applied in this study to investigate the antiviral activity of this drug as well as yingtelong and axiluowei as positive control.The guinea pig model of vaginitis and skin infection caused by HSV-2 infection were established,treated with IFNα-2b suppository at dosages of 60000、180000、540000 IU,using IFNα-2b injection 180000 IU·kg-1 as controls.Score the pathological changes of appearance and skin,the virus activities of vaginal secretion and tissue sections of viginae were assayed after treatment.Results The TD50 of IFN α-2b and yingtelong for Vero cells was(>100)μg·mL-1 and(>100000)IU·mL-1,respectively.The IC50 of IFN α-2b and yingtelong and axiluowei for Herpes virus type 1 was(0.29±0.08)μg·mL-1 and(185.0±28.8)IU·mL-1 and(0.19±0.03)μg·mL-1,respectively.The mean scores for vaginal and skin lesion of the treated groups were lower than those of untreated group.Among these concentrations,the IFNα-2b suppository of 540000 IU·kg-1 group.Showed highest anti-viral activity.The virus activity in vaginal secretion of treated group was lower than that of untreated group too(P<0.01 or P<0.05).Tissue sections of viginae after treatment with IFNα-2b suppository showed significantly therapeutical effects on the degrees of vaginal lesion.At the same dosage,The anti-HSV activity of IFNα-2b suppository was also compared with IFNα-2b injection,the results showed that the activity of suppository of 540000 IU·kg-1 group was similar to that of the injection.Conclusions The IFNα-2b suppository has anti-viruses function both in vivo and in vitro.

Development of novel interferon alpha2b muteins and study the pharmacokinetic and biodistribution profiles in animal model

Novel human interferon alpha 2b (hIFNα2b) muteins were developed by substituting cysteine residue (C) at positions 2 and 99 with aspartic acid residues (D). The mutein forms were then studied for pharmacokinetic profile. In addition, the influence of charge on the protein structure was tested in vivo for the biodistribution pattern. Codon substitutions were performed by Polymerase Chain Reaction (PCR)-based site-directed mutagenesis on a previously constructed synthetic hIFNα2b open reading frame (ORF) cloned in pET32b expression plasmid. The result of nucleotide sequencing analysis confirmed that all codons were replaced successfully without any additional mutation. Three mutant forms of hIFNα2b ORF were overexpressed in Escherichia coli BL21 (DE3) resulted in three muteins: hIFNα2b C2D, hIFNα2b C99D, hIFNα2b C2D C99D. To follow the kinetic and localization of the mutein interferon after intravenous administration, Tc99m was used to label the proteins. In particular of elimination half-life, it was shown that hIFNα2b C2D C99D > hIFNα2bC2D > hIFNα2bC99D > wild type. hIFNα2b C2D C99D mutein showed highest blood accumulation after 30 minutes administration. Taken together, the charge of hIFNα2b seems to be responsible for the fate of hIFNα2b in vivo.

Effects of interferon α-2b on liver function, complement level and oxidative stress in patients with hepatitis B

Objective:To observe the effect of interferonα-2b treatment on liver function,liver fibrosis,complement protein and oxidative stress in patients with hepatitis B.Methods:A total of 100 patients with hepatitis B in our hospital were randomly divided into the control group and the observation group,with 50 cases in each group.After admission,patients in the control group were treated with entecavir,while patients in the observation group were treated with interferonα-2b combined with entecavir.The levels of serum total bilirubin(TBil),aspartate aminotransferase(AST),alanine aminotransferase(ALT),type III procollagen(PCIII),type IV collagen(CIV),complement C3 protein(C3),complement C4 protein(C4),malondialdehyde(MDA),superoxide dismutase(SOD)and nitric oxide(NO)were compared between the two groups before and after treatment.Results:After treatment,the levels of TBil,AST,ALT,PCIII,CIV,MDA and NO in serum of patients with hepatitis B in both groups were significantly lower than those before treatment,and the levels of C3,C4 and SOD were significantly higher than those before treatment(P<0.05).After treatment,the levels of TBil,AST,ALT,PC III,C IV,MDA and NO in serum of patients in the observation group were significantly lower than those in the control group,while the levels of C3,C4 and SOD in serum of patients in the observation group were significantly higher than those in the control group(P<0.05).Conclusions:The combination of interferonα-2b and entecavir has a good curative effect on hepatitis B.It can significantly improve the liver function and immune function of patients,delay the process of liver fibrosis and reduce oxidative stress injury.It is worthy of clinical promotion.

SYNERGIC CYTOTOXICITY TO GASTRIC CANCER CELLS BY COMBINED USE OF TRICHOSANTHIN ANDRECOMBINANT INTERFERON α-2B

Objective To investigate a new approach of the combined use of trichosanthin (TCS) andrecombinant interferon alpha - 2b (rIFN α- 2b) against digestive system cancer cells. Methods Detect separatelythe cytotoxicity of TCS, rIFN α- 2b and their combination against digestive system cancer cell SGC- 7901.Results In the experiment in vitro, TCS, rIFN α- 2b both had direct, dose dependent cytotoxicity againstSGC - 7901. Their combined use demonstrated a toxicity signijicantly higher than that of the two drugs used alone,showing a signilicant synergic effect. This synergic cytotoxicity was confirmed in the animal experiment.Conclusion Combined use of TCS and rIFN α - 2b decreases the therapeutic dose of TCS and its toxic adverseellect, and this synergic effect is favorable to the clinical use of TCS protein against gastric cancer.

Effects of anti-HPV bioprotein dressing combined with interferon α-2b therapy on the malignant molecule expression in patients with CINⅢ complicated by high-risk HPV positive

Objective: To study the effects of anti-HPV bioprotein dressing combined with interferon α-2b therapy on the malignant molecule expression in patients with cervical intraepithelial neoplasia (CIN) Ⅲ complicated by high-risk HPV positive. Methods: Patients who were diagnosed with CINⅢ and high-risk HPV positive and underwent conization in the 3201 Hospital Affiliated to Xi'an Jiaotong University between June 2014 and February 2017 were selected and randomly divided into the observation group who received preoperative anti-HPV bioprotein dressing combined with interferon α-2b therapy and the control group who received no special treatment. CIN lesion was collected to determine the expression of pro-proliferation molecules, pro-apoptosis molecules and epithelial-mesenchymal transition molecules. Results: Rsf1, Piwil2, TOPK, p38MAPK, ERK, Snail, Twist, N-cadherin and Vimentin mRNA expression in cervical intraepithelial neoplasia lesions of observation group were greatly lower than those of control group whereas LRIG3, SARI, IEX-1, FHIT and E-cadherin mRNA expression were greatly higher than those of control group. Conclusion: Anti-HPV bioprotein dressing combined with interferon α-2b therapy can inhibit the proliferation and invasive growth of tumor cells in patients with CINⅢ complicated by high-risk HPV positive.

重组人干扰素-α2a(IFN-α2a)的圆二色谱分析

目的:研究测量温度和蛋白质浓度对重组人干扰素-α 2a(rhIFN-α 2a)圆二色谱的影响,进而研究对 rhIFN-α 2a 二级结构比例的影响。方法:分别研究了测量温度和蛋白质浓度对 rhIFN-α 2a 圆二色谱的影响,另外还对不同厂家、不同批次的4批 rhIFN-α 2a 的圆二色谱进行了比较。结果:测量温度在60～95℃之间,rhIFN-α 2a 圆二色谱的形状发生改变,三级结构遭到破坏,二级结构发生改变;在5～60℃温度区间,二级结构相对稳定。rhIFN-α2a 的各二级结构比例在1.5～0.006nag·mL^(-1)范围内相对稳定。不同厂家、不同批次的4批 rhIFN-α 2a 的圆二色谱形状基本一致,4种二级结构的比例相近。结论:在一定的温度和浓度范围内,rhIFN-α 2a 的圆二色谱相对稳定,且不同批次的测量结果具有很好的一致性。圆二色谱可用于蛋白质类药物的质量控制。

干扰素α-2a与肝纤维化大鼠肝星状细胞的凋亡

背景:干扰素α-2a改善肝纤维化的机制直到目前仍尚未阐明。目的:进一步验证干扰素α-2a对CCl4诱导大鼠肝纤维化模型中肝星状细胞凋亡的影响。方法:建立CCl4诱导肝纤维化模型,健康SD雌性大鼠50只,采用随机对照原则将SD大鼠分成5组,即生理盐水对照组、纤维化模型组、6×104U/kg干扰素α-2a干预组、12×104U/kg干扰素α-2a干预组及6×104U/kg干扰素α-2a对照组。造模8周时取肝组织标本,分别进行肝纤维化指标检测;RT-PCR分析肝组织bcl-2、bax的表达;免疫组织化学染色用a平滑肌肌动蛋白对活化的肝星状细胞进行标记。结果与结论:肝组织病理形态显示CCl4诱导肝纤维化成功建立,表现为纤维化模型组汇管区周围纤维化明显,有芒状纤维和纤维间隔形成,各干扰素α-2a干预组肝纤维化有不同程度缓解。纤维化模型组有大量a平滑肌肌动蛋白阳性表达,6×104U/kg干扰素α-2a干预组a平滑肌肌动蛋白阳性表达较纤维化模型组减少,12×104U/kg干扰素α-2a干预组更少,6×104U/kg干扰素α-2a对照组未见a平滑肌肌动蛋白阳性表达。结果提示干扰素α-2a能下调CCl4诱导肝纤维化bcl-2的表达,及上调bax的表达。提示干扰素α-2a阻断CCl4诱导肝纤维化机制存在通过调节bcl-2、bax的表达,诱导肝星状细胞凋亡途径,该调节作用可能与干扰素α-2a剂量相关。

聚乙二醇干扰素α-2a联合利巴韦林治疗慢性丙型肝炎的疗效及不良反应

目的:观察聚乙二醇干扰素α-2a(PEG-IFNα-2a)联合利巴韦林治疗慢性丙型肝炎的疗效及不良反应。方法:回顾性分析在本院门诊接受抗病毒治疗的63例慢性丙型肝炎。各型患者均给予PEG-IFNα-2a和利巴韦林,疗程48周。分别在治疗前、治疗后4周、12周、24周、治疗结束时、治疗结束后24周及48周测定患者血清HCV RNA水平,观察不良反应发生率。结果:58.7%(37/63)的患者获得快速病毒学应答,68.2%(43/63)获得早期应答,73%(46/63)获得治疗结束后应答,治疗结束后随访24周时65%(41/63)HCV RNA仍为阴性,48周时有57.1%(36/63)仍为阴性。63例患者中有5例因为药物副作用终止干扰素治疗,完成治疗的患者,主要不良反应为感冒样症状、消化道症状、血常规异常、精神症状及甲状腺疾病。结论:PEG-IFNα-2a联合利巴韦林治疗慢性丙型肝炎疗效确切、安全,及时发现药物不良反应并采取适当措施,能够确保患者完成治疗疗程。

聚乙二醇干扰素α-2a联合利巴韦林治疗转氨酶持续正常慢性丙型肝炎3年随访

目的:观察聚乙二醇干扰素(PEG-IFN)α-2a联合利巴韦林治疗转氨酶持续正常的慢性丙型肝炎(CHC)远期疗效。方法:选择68例丙氨酸转移酶(ALT)持续正常CHC患者为观察组,50例ALT升高的CHC患者为对照组,均接受PEG-IFNα-2a每周一次皮下注射,同时口服利巴韦林,HCVRNA基因型为1b或未分出型者疗程为48周,基因为2a型者疗程24周。两组患者均随访至停药后3年,内容包括持续病毒学应答、生化应答、影像学改变及生存质量评估。观察组和对照组分别有51例和40例完成3年随访。结果:随访至3年末,观察组和对照组患者均获得相似的较高持续病毒学应答率(80.4%vs80.0%,P=1.000),随访1年末时获得持续病毒学应答(SVR)的病例在后2年的随访中无一例复发。取得SVR的患者均保持了持续生化学应答和影像学稳定,同时两组患者生存质量也得到提高,尤其是社会功能、活力、总健康状况、情绪角色及心理健康5个领域改善明显。两组间比较无统计学差异(P>0.05)。结论:PEG-IFNα-2a联合利巴韦林治疗转氨酶持续正常的慢性丙型肝炎可取得与ALT升高者相似的远期疗效。

小柴胡汤联合聚乙二醇干扰素α-2a治疗慢性丙型肝炎的临床研究

目的评价小柴胡汤联合聚乙二醇干扰素α-2a治疗慢性丙型肝炎的临床效果。方法将50例慢性丙型肝炎患者随机分成治疗组与对照组,治疗组26例,对照组24例。对照组给予聚乙二醇干扰素α-2a治疗,治疗组患者在对照组治疗的基础上加用小柴胡汤。疗程6个月,两组停药后随访6个月。分别观察两组慢性丙肝患者治疗前后的临床症状、生化应答率、病毒应答率。结果治疗结束时治疗组显效率、有效率和总有效率分别是69.23%、19.23%、88.46%,对照组分别是66.67%、16.67%、83.33%,两组比较差异无统计学意义(P>0.05)。停药后6个月治疗组持续有效完全应答为46.15%,而对照组为16.67%,两组比较差异有统计学意义(P<0.01)。结论小柴胡汤联合聚乙二醇干扰素α-2a治疗慢性丙型肝炎,可缓解患者的症状体征,促进HCV-RNA的阴转,值得临床应用。

聚乙二醇干扰素α-2a应用剂量与慢性丙型肝炎抗病毒疗效的关系

目的:探讨聚乙二醇干扰素α-2a(PEG-IFNα-2a)应用剂量与慢性丙型肝炎抗病毒疗效的关系。方法:选取本院慢性丙型肝炎患者67例,采用随机数字表法将患者分为高剂量组32例和低剂量组35例,全部患者均采用PEG-IFNα-2a联合利巴韦林治疗,其中高剂量组采用PEG-IFNα-2a 180μg/次,低剂量组90μg/次,1次/周,皮下注射,比较两组抗病毒治疗疗效差异。结果:高剂量组应答率明显高于低剂量组,两组应答率比较差异有统计学意义(P<0.05);治疗前,两组肝功能(ALT、AST)指标比较差异无统计学意义(P>0.05),治疗后,全部患者上述指标均明显低于治疗前,其中高剂量组上述指标明显低于低剂量组,两组比较差异有统计学意义(P<0.05);但高剂量组不良反应发生率明显高于低剂量组,两组比较差异有统计学意义(P<0.05)。结论:聚乙二醇干扰素α-2a应用剂量与慢性丙型肝炎抗病毒疗效具有明显相关性,其中高剂量PEG-IFNα-2a临床疗效更佳,但增加药物副作用。

香菇多糖L-2对荷瘤小鼠TNF-α和IL-2的影响(英文)

我们提取纯化得到一种重均分子量为2.03×105、单糖为葡萄糖的香菇多糖级分(L-2)后,评价了香菇多糖L-2对荷S-180小鼠细胞免疫的影响。连续10d通过腹腔注射给予小鼠不同剂量的香菇多糖L-2(10mg/kg体重),测定了正常小鼠与荷S-180小鼠的血清中肿瘤坏死因子(TNF-α)和白介素2(IL-2)的含量,以及香菇多糖L-2对TNF-α和IL-2的mRNA表达的影响。与对照组小鼠相比,血清中TNF-α含量有显著增加,而血清中IL-2含量没有变化,与此同时,香菇多糖L-2可以上调TNF-α的mRNA的表达。结果揭示多糖L-2有增加TNF-α含量的作用,多糖增强免疫力与TNF-α含量增加以及在转录水平上调TNF-αmRNA的表达有关。

聚乙二醇干扰素α-2a治疗HBeAg阳性慢性乙型肝炎部分应答患者序贯替比夫定治疗疗效观察

目的探讨在聚乙二醇干扰素α-2a治疗的HBeAg阳性慢性乙型肝炎(CHB)部分应答患者序贯替比夫定继续治疗的临床疗效。方法2016年1月~2017年2月我院感染病科收治的63例HBeAg阳性CHB患者在应用聚乙二醇干扰素α-2a治疗48周后呈部分应答的患者,其中31例在停止干扰素治疗后接受替比夫定序贯治疗48周,另32例则停药观察48周。两组随访24周。结果在治疗或观察24周、48周和随访24周,序贯治疗组患者血清HBeAg转阴率分别为22.5%、25.8%和35.4%,均显著高于停药观察组的0.0%、3.2%和3.2%(P<0.05),在治疗或观察48周和随访24周,序贯治疗组血清HBV DNA转阴率为90.3%和87.0%,显著高于停药观察组的34.3%和18.7%(P<0.05),ALT复常率为96.7%和90.3%,显著高于停药观察组的75.0%和25.0%(P<0.05);在治疗或观察48周和随访24周,序贯治疗组血清HBV DNA水平为(2.6±0.3)lgIU/mL和(1.9±0.1)lgIU/mL,显著低于停药组的【(4.5±0.7)lgIU/mL和(5.5±0.2)lgIU/mL,P<0.05】,血清ALT水平分别为(56.3±2.4)IU/L和(43.3±3.1)IU/L,显著低于停药组【分别为(60.1±7.2)IU/L和(71.3±2.8)IU/L,P<0.05】,在随访24周,序贯治疗组血清HBsAg水平为(2.0±0.2)lg IU/mL,显著低于停药组【(2.6±0.3)lg IU/mL,P<0.05】;序贯治疗组在48周治疗期间,其中9例(29.0%)患者在服用替比夫定期间出现血清肌酸激酶升高现象,在治疗10~13周后下降至正常水平。结论对于经聚乙二醇干扰素α-2a治疗结束后呈部分应答的血清HBeAg阳性CHB患者序贯应用替比夫定继续治疗48周,发现能够有效提高患者血清HBV DNA转阴率和ALT复常率,且安全性较高。

聚乙二醇干扰素α-2a联合胸腺肽α1治疗对慢性乙型肝炎患者生存质量的影响

目的 探讨聚乙二醇干扰素（PEG-IFN）α-2a联合胸腺肽α1（Tα1）治疗对慢性乙型肝炎（CHB）患者生存质量（QOL）的影响.方法 选择2008年10月至2012年10月本科收治的CHB患者148例,随机分为观察组和对照组各组74例,对照组采用PEG-IFNα-2a治疗;观察组采用PEG-IFNα-2a联合Tα1治疗,比较分析两组患者治疗3、6、12个月时HBV DNA载量的变化情况,QOL及慢性肝病问卷（CLDQ）评分和不良反应.组间比较采用独立样本t检验,治疗前后比较采用配对t检验,计数资料比较采用χ2检验.结果 观察组治疗3、6、12个月时HBV DNA载量下降值和病毒学应答率均明显高于对照组（t=2.281,P=0.02;χ2=3.950,P=0 04;t=3 237,P=0.00;χ2=4.022,P=0.04;t=3.197,P=0.00; χ2=4.028,P=0.04）;观察组治疗6个月时总的QOL、生理、社会关系评分及乏力、焦虑评分明显高于对照组（t=2.039~3.472,P＜0.05）;观察组治疗12个月总的QOL、总的健康状况、生理、心理、社会关系评分及乏力、全身症状、活动、焦虑、环境评分明显高于对照组（t=2.020～3.201,P＜0.05）.结论 PEG-IFNα-2a联合Tα1治疗CHB可增强患者机体免疫力及抗病毒能力,提高机体清除HBV的能力,从而提高患者生存质量,值得临床推广.

干扰素α-2a栓治疗宫颈糜烂356例

目的 :观察干扰素α 2a(interferonα 2a)栓治疗宫颈糜烂的疗效。方法 :宫颈糜烂病人 35 6例 ,年龄 (32±s 11)a ,随机分为A组 140例 ,应用干扰素α 2a栓阴道放置 ,隔日 1次 ,9枚为一个疗程 ,共2疗程。B组 12 2例 ,采用光热治疗。C组 94例 ,光热治疗后应用干扰素α 2a栓 2个疗程。治疗 3mo后观察各组疗效 ,6mo后观察复发数。结果 :A ,B ,C 3组痊愈例数分别为 116,99,82例 ,3种治疗方法间的疗效无显著差异 (P >0 .0 5 ) ;A ,B ,C 3组复发数分别为 10 ,15 ,7例 ,3组间差异无显著意义 (P >0 .0 5 ) ;A组不良反应明显较B ,C组轻。结论 :干扰素α 2a栓治疗宫颈糜烂效果与光热治疗、干扰素栓加光热治疗相似 ,但不良反应小、方便易行 。