PEG-干扰素α-2a治疗低转氨酶乙型肝炎患者的回顾性研究  

Retrospective study on PEG-IFNα-2a therapeutics in hepatitis B patients with low ALT activity

作　　者：李慧涓[1] 王松[1] 何清[1] 许诚[1] 李知玉[1] 舒丹[1] 唐奇远[1] 纪燕华[1] 乐晓华[1] 

机构地区：[1]深圳市东湖医院,广东深圳518020

出　　处：《中华实验和临床感染病杂志（电子版）》2009年第2期28-31,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的对于PEG-干扰素α-2a(PEG-IFNα-2a)治疗的低转氨酶水平慢性乙型肝炎患者进行回顾性研究。方法对治疗满48周并于治疗前完成肝活检的乙型肝炎患者,取用药后第12周、24周、48周为观察点,记录乙型肝炎病毒血清标志物与HBV DNA的变化情况,并分析其应答与肝组织炎症程度(G分级)、肝细胞HBcAg分布的相关程度。结果按炎症级别分组之HBeAg阳性组:治疗48周时G1组总有效率20%(2/10),G2组总有效率56.25%(9/16),G3组100%(6/6);HBeAg阴性组炎症级别G1组10%(1/10),G2组62.5%(5/8),G3组100%(2/2)。按照肝细胞HBcAg表达分组之HBeAg阳性组:48周时浆型表达总有效率80%(8/10),混合型表达组总有效率42.1%(8/19),阴性表达组100%(3/3)。HBeAg阴性组:浆型分布组DNA阴转率为37.5%(3/8),混合型组为28.57%(2/7),阴性组为60%。结论无论按照炎症还是肝细胞HBcAg表达分组比较,最初统计学处理后发现各个级别分组所得数据未见明显差异(包括HBeAg阳性与阴性组)。加入时间因素后显示随时间延长,高炎症水平、HBcAg的阴性表达和(或)浆型表达会有更高的疗效。Objective To observe the clinical curative effect of PEG-IFNα-2a in chronic hepatitis B with low ALT activity, retrospectively. Methods For the chronic hepatitis B cases who have accomplished 48 weeks treatment and had performed liver biopsy before treatment, sera HBV markers and HBV DNA were sampled in the 12th, 24th and 48th week of treatment in order to analyze the relativity between response to PEG-IFNα-2a and inflammation level of hepatic tissue （G classification） and HBcAg distribution in hepatic cells. Results For different inflammation levels in HBeAg positive cases, the total effective rate in the 48th week, G1 group is 20% （2/10）, G2 is 56.25% （9/16）, G3 is 100% （6/6） ; In HBeAg negative cases, the total effective rate in the 48th week, G1 group is 10% （ 1/10）, G2 is 62.5% （5/8）, G3 is 100% （2/2）. For expression of HBeAg in HBeAg positive cases, the HBV DNA negative rate in the 48th week, cytoplasm type is 80% （8/10）, mixed type is 42.1% （8/19）, negative type is 100% （3/3） ; In HBeAg negative cases, cytoplasm type is 37.5% （3/8）, mixed type is 28.57% （2/7）, negative type is 60% （3/5）. Conclusions Either in inflammation level or expression of HBcAg, statistics indicates there was no obvious difference at the beginning stage of treatment, including HBeAg positives and negatives. Along with the further treatment, the higher effective ratio will take place in the high inflammation level, negative expression of HBcAg and/or cytoplasm expression cases.

关 键 词：乙型肝炎病毒 干扰素 低转氨酶活性 

分 类 号：R512.62[医药卫生—内科学] R752.53[医药卫生—临床医学]