干扰素α1b改善慢性乙型肝炎患者肝纤维化的疗效观察  

The role of interferon α1b in amelioration of hepatic fibrosis of liver in chronic viral hepatitis type B

作　　者：王昆[1] 闫亮[2] 

机构地区：[1]解放军总医院医务部药材处,北京100853 [2]解放军第三〇二医院医务部,北京100039

出　　处：《感染．炎症．修复》2009年第2期99-101,共3页Infection Inflammation Repair

摘　　要：目的:探讨应用干扰素α1b治疗慢性乙型肝炎(乙肝)患者改善其肝纤维化情况的疗效观察。方法:2005年3月-2008年2月期间门诊经病理确诊的慢性乙肝致肝纤维化患者96例,随机分为干扰素治疗组(46例)和对照组(50例),两组均给予常规中药保肝降酶治疗,干扰素治疗组加用干扰素α1b(商品名运德素)50μg肌肉注射,隔日1次,疗程均为24周。观察两组患者症状、体征,肝功能指标如丙氨酸转氨酶(ALT)、胆红素(BIL)、白蛋白(A)和白蛋白/球蛋白比例(A/G),以及肝纤维化指标血清透明质酸(HA)、层黏连蛋白(LN)、Ⅲ前型胶原(PCⅢ)和Ⅳ型胶原(CⅣ)的变化。结果:与对照组比较,干扰素治疗组治疗后腹胀、肝区疼痛、脾肿大、肝肿大等临床症状和体征明显改善(P<0.05),ALT[(55.7±20.2)U/Lvs.(133.4±56.3)U/L,P<0.01]、BIL[(32.9±21.5)μmol/Lvs.(46.7±26.8)μmol/L,P<0.01]水平下降明显,血清A[(41.8±7.5)g/Lvs.(37.9±7.8)g/L,P<0.01]和A/G(1.8±0.6vs.1.7±0.3,P<0.01)显著升高,HA[(101.8±50.2)ng/mlvs.(149.9±54.3)ng/ml,P<0.01]、LN[(93.3±23.7)ng/mlvs.(122.1±37.4)ng/ml,P<0.01]、CⅣ[(104.6±23.1)ng/mlvs.(107.3±34.7)ng/ml,P<0.01]和PCⅢ[(190.7±59.0)ng/mlvs.(260.1±83.5)ng/ml,P<0.01]等肝纤维化指标也明显下降,干扰素治疗组与对照组比较各检查指标差异均有显著性。结论:应用干扰素α1b治疗慢性乙肝致肝纤维化患者对改善患者临床症状、体征,促进肝功能恢复,改善其肝纤维化有显著疗效。Objective： To observe the effectiveness of interferon （IFN） α1b treatment of patients with chronic viral hepatitis type B to ameliorate liver fibrosis. Methods：From March 2005 through February 2008, a total of 96 patients with pathological diagnosis of chronic viral hepatitis type B patients with hepatic fibrosis were randomly divided into IFN treatment group （46 cases） and control group （50 cases）. Both groups were given conventional treatment with medicines such as Liuwei Wuling tablet （六味五灵片） to protect liver and reduce enzyme values. In IFN group, IFN alb 50 μg was given subcutaneously or intramuscularly, once every other day, for a course of 24 weeks. In both groups of patients,their symptoms, liver function and liver fibrosis indicators such as ALT,BIL, albumin, A/G,HA, LN, PCⅢ and CⅣ were recorded and analyzed. Results： Comparing IFN treatment group with control group, the symptoms and physical signs were obviously improved after the IFN treatment, such as abdominal distention, liver area pain, spleen enlargement, hepatomegaly （P〈0.05）, levels of ALT[（55.7 ± 20. 2）U/L vs. （133.4±56.3）U/L,P〈0. 01], BIL（32. 9±21.5）μmol/L vs. （46.7±26.8）μmol/L,P〈0. 01] were lowered obviously,and levels of serum albumin[（4]. 8± 7.5）g/L vs. （37.9± 7.8）g/L,P〈0.01]and A/G （1.8± 0. 6 vs. 1.7 ± 0.3, P〈0.01） were significantly increased, and levels of liver fibrosis indicators, such as HA [（101.8±50.2） ng/ml vs. （49.9±54.3）ng/ml,P〈0. 01],LN1-（93.3±23.7）ng/ml vs. （122. 1±37.4）ng/ml,P 〈0. 01] ,CⅣ （104. 6 ± 23.1） ng/ml vs. （107.3±34.7）ng/ml,P〈0.01] and PC Ⅲ [（190. 7 ± 59- 0） ng/ml vs. （260. 1 ± 83.5）ng/ml, P 〈 0. 013 were also decreased obviously, with statiscally significant differences . Conclusion： The treatment of IFN αlb in patients with chronic viral hepatitis type B patients can obviously improve the clinical symptoms and signs, promote liver function, enhance the recovery of liver fibr

关 键 词：慢性乙型肝炎 肝纤维化 干扰素Α1B 

分 类 号：R512.62[医药卫生—内科学] R512.6[医药卫生—临床医学]