肝组织学检查对慢性乙型肝炎患者抗病毒治疗的筛选价值  

Response to interferon α1b therapy of patients with chronic hepatitis B based on inclusion by Liver pathological examination

作　　者：安萍[1] 吕丹[1] 卞丽[1] 王静波[1] 曹艳雪[1] 张殊娜 戴文颖[1] 许春[1] 

机构地区：[1]沈阳市传染病医院肝病研究所,110006

出　　处：《实用肝脏病杂志》2005年第3期134-135,共2页Journal of Practical Hepatology

摘　　要：目的探讨肝穿刺病理检查在慢性乙型肝炎抗病毒治疗选择中的应用价值。方法150例临床诊断为慢性乙型肝炎的患者行肝穿刺,用HAI系统对肝脏组织学进行评分,HAI评分为4分≤得分≤16分者纳入观查组,而得分<4或>16分者被剔除观察组。观察组94例及未肝穿对照组83例采用α1b干扰素500万单位肌肉注射,1次/日×1月,1次/隔日×5月,停药后随访6个月。结果经过筛选的观察组94例患者对干扰素的完全应答率(44.7%)明显高于对照组(24.1%,P<0.01);HAI评分在4分～8分的患者对于干扰素的完全应答率(30.0%)与对照组(24.1%)比较,P>0.05,无显著差异。而HAI评分在8分～12分者及12分～16分者对于干扰素的完全应答率分别为67.7%、65.2%,与对照组比较P均<0.01,差异显著。结论经过肝穿刺病理选择的慢性乙型肝炎患者对干扰素治疗效果明显高于未经肝穿选择的患者,且肝脏组织学评分越高的患者对干扰素的疗效越好。Objective To investigate the value of patients with chronic hepatitis B receiving interferin α1b therapy.Methods 150 biopsy proven and 83patients who did not have liver pathological exam with hepatitis B received interferon α1b therapy for six months and followed up for six months.Results The complete response rate in 94 biopsy selected patients with hepatitis B was 44.7%,much higher than 24.1% in control group( P <0.01);the patients with hepatic activity index score at 8 to 12 had more chance of complete response to interferon α1b.Conclusion The interferon α1b therapy for patients with chronic hepatitis B at the base of liver pathological examination will improve the complete response.

关 键 词：慢性乙型肝炎患者 抗病毒治疗 筛选价值 肝组织学 完全应答率 肝穿刺病理检查 肝脏组织学 查对 αlb干扰素 P〉0.05 HAI 对照组 观察组 应用价值 临床诊断 肌肉注射 差异显著 治疗效果 评分 500 停药后 

分 类 号：R512.62[医药卫生—内科学] R737.9[医药卫生—临床医学]