α-干扰素治疗成人乙型肝炎病毒相关肾炎的疗效观察  

The observation of therapeutic effect of interferon-α on adult patients with HBV associated glomerulonephritis

作　　者：王朝晖[1] 陈楠[1] 任红[1] 张文[1] 陈晓农[1] 陆志檬[2] 

机构地区：[1]上海交通大学附属瑞金医院肾内科,上海200025 [2]上海交通大学附属瑞金医院传染科,上海200025

出　　处：《中国实用内科杂志：临床前沿版》2006年第1期121-123,共3页

基　　金：上海市科委重大项目(No.03JC14084);上海市卫生局领先专业重点学科基金(983009)资助项目

摘　　要：目的 观察α-干扰素治疗成人乙型肝炎病毒（hepatitis B virus，HBV）相关肾炎的疗效。方法 对1996—09—2003—03上海交通大学附属瑞金医院9例HBV相关肾炎患者予以α-干扰素治疗。300×10^4U隔日治疗，疗程6—9个月，观察治疗前后蛋白尿、血清HBV标志物和分支链DNA（branched DNA，bDNA）等情况的变化。结果 经治疗，患者尿蛋白排泄量显著减少（P〈0．05）；9例患者中，8例患者蛋白尿有不同程度的减少，24h尿蛋白减少量为0．55—9．50g，其中3例蛋白尿消失，4例肾病综合征缓解。9例患者乙肝表面抗原（HBsAg）均未转阴，6例乙肝e抗原（HBeAg）阳性者3例转阴。9例患者检测了血清HBVbDNA，8例患者bDNA下降伴蛋白尿好转，1例bDNA无好转伴持续大量蛋白尿。α-干扰素治疗成人乙肝病毒相关肾炎总有效率为78％。无明显不良反应。结论 抗病毒药物α-干扰素治疗成人HBV相关肾炎具有一定效果。治疗有效者蛋白尿减少，体内病毒复制下降，由此证实病毒复制在HBV相关肾炎中的作用。Objective To observe the therapeutic effect of interferon - α on adult patients with HBV associated glomeru- lonephritis. Methods Nine patients with HBV associated glomerulonephritis diagnosed in Shanghai Ruijin Hospital from September 1996 to March 2003 were treated with interferon - α at a dose of 3 million units every other day and the total period was 6 to 9 months. The proteinuria, serum HBV marks and bDNA were measured before and after therapy. Results At the end of the therapy urinary protein excretion significantly reduced （ P 〈 0. 05 ） . Among 9 patients, 8 had reduction of urinary protein excretion varying from 0. 55 to 9. 50 g/24 h, including 3 disappearance of proteinuria and 4 remission of nephrotic syndrome. None of 9 patients lost HBsAg, but 3 of 6 patients＇ serum HBeAg disappeared. In all the patients who were monitored by HBV bDNA assay, 8 had reduction in bDNA with urinary protein excretion decreasing and 1 had no change in bDNA with persistent heavy proteinuria. The rate of therapeutic effect of interferon - α on adult patients with HBV associated glomerulonephritis was 78% with no significantly side effect. Conclusion Interferon - α, as an antiviral medicine, is beneficial in the treatment of HBV associated glomerulonephritis with decrease of proteinuria and bDNA concentration. In addition, the pathogenic role of HBV replication in HBV associated glomerulonephritis is confirmed by the therapy of interferon - α.

关 键 词：乙型肝炎病毒 肾小球肾炎 Α-干扰素 BDNA 

分 类 号：R5[医药卫生—内科学]