干扰素α治疗慢性乙型肝炎患者肝纤维化的实验研究  

Effect of interferon alpha on liver fibrosis in patients with chronic hepatitis B

作　　者：于宏[1] 曹治宸[1] 耿建英[1] 贺占国[1] 王政民[1] 孙小云[1] 王中华[1] 

机构地区：[1]中国人民解放军白求恩国际和平医院肝病科,河北石家庄050082

出　　处：《第一军医大学学报》2005年第11期1409-1412,共4页Journal of First Military Medical University

基　　金：白求恩和平医院科研基金资助课题(008号)~~

摘　　要：目的观察干扰素α对慢性乙型肝炎(乙肝)患者肝组织纤维化程度的影响。方法选取病理诊断为S3￣S4期的16例乙肝患者,干扰素治疗期前后3次进行肝组织炎症程度及纤维化程度病理分析,免疫组化检测肝组织TGF-β1蛋白、Fas及HBcAg抗原,TUNEL方法观察肝细胞凋亡情况。同期检测血清肝纤维化指标及肝功能。结果在S3￣S4期,患者Fas、TGF-β1显著表达,肝细胞的DNA损伤严重。干扰素α治疗3个月后Fas抗原、TGF-β1表达程度显著下降(P<0.05);细胞凋亡程度减轻(P<0.05);肝组织HBcAg表达程度无显著改变;连续6￣9个月治疗后,肝组织炎症及纤维化程度逐渐改善(P<0.05),血清肝纤维化指标及肝功能水平与治疗前差异显著。结论干扰素α能显著改善S3￣S4期患者肝细胞凋亡和肝组织纤维化程度,但需持续治疗。Objective To observe the histological changes in the fibrotic and inflammatory tissues in response to interferon alpha treatment in patients with chronic viral hepatitis B. Methods Sixteen patients with chronic viral hepatitis B in S3-S4 stages established by pathological examination were treated with interferon alpha for 6-9 months, and the degree of liver fibrosis and inflammation were examined 3 times during the treatment. The expression of Fas, transforming growth factor β1 （TGFβ1） and HBcAg in the liver tissues were detected by immunohistochemistry, and DNA fragmentation was examined by TUNEL assay. The levels of the serum markers for liver fibrosis and liver function were also measured. Results Patients with liver fibrosis in S3-S4 stages had high pathological expression of Fas and TGFβ1 with severe DNA damage in the liver tissues. After 3 months of interferon therapy, the expression of Fas and TGFβ1 were lowered （P〈0.05）, and further treatment till 3-9 months resulted in gradual decrease in the degree of hepatic fibrosis and cell apoptosis （P〈0.05）, with improved serum liver fibrosis indices and liver function. Conclusion Interferon alpha may alleviate liver fibrosis and suppress cell apoptosis in patients in S3-S4 stages after a 6-to 9-month continuous treatment.

关 键 词：乙型肝炎 干扰素Α 肝纤维化 细胞凋亡 FAS基因 TGF-Β1基因 

分 类 号：R512.62[医药卫生—内科学]