长疗程低剂量α-干扰素口含治疗丙型肝炎合并庚型肝炎的临床流行病学研究  

A Clinical Epidemiological Study on HGV Infection with α-interferon Therapy

作　　者：凌斌华[1] 庄辉[1] 朱万孚[1] 杜珩[1] 王淑萍 

机构地区：[1]北京大学医学部病原生物学系,100083 [2]河南周口地区卫生防疫站

出　　处：《中国公共卫生》2001年第4期292-294,共3页Chinese Journal of Public Health

基　　金：博士学科点专项科研基金

摘　　要：目的　了解庚型肝炎病毒 (HGV)对α 干扰素治疗的反应以及治疗前后HGV与丙型肝炎病毒 (HCV)合并感染者病毒血症的动态变化。方法　对研究对象用药前、用药 3和 6个月时肝功能、血清HGVRNA及HCVRNA等的动态变化进行观察。以阳性率和阴转率为主要评价指标并经统计学分析。结果　经α 干扰素治疗 3和 6个月时 ,治疗组的ALT水平呈下降趋势 ,特别是治疗 6个月时 ,ALT平均水平从治疗前的119 6IU/L降至 5 6 2IU/L ,显著低于 6个月时安慰剂组ALT平均水平 (12 6IU/L)。治疗组血清HGVRNA阴转率在治疗 3和 6个月时分别为 6 4 7%和 6 4 7% ,安慰剂组分别为 6 0 0 %和 6 6 7%。两组无显著性差异。用α 干扰素治疗的 17例病人中 ,于治疗 6个月时 ,3例血清HGVRNA阴转而HCVRNA仍为阳性的病人 ,其ALT水平仍维持在较高水平 ,分别为15 4、16 8和 84IU/L。 3例血清HGVRNA阳性而HCVRNA阴转者 ,其ALT水平均转为正常 ,分别为 2 5、2 0和 2 0IU/L。 3例血清HGV和HCVRNA均阳性者 ,其ALT水平仍为异常。8例HGV和HCVRNA均阴转者 ,除 1例ALT由 70IU/L降至 35IU/L外 ,其余 7例病人的ALT均降低至正常水平。结论　HGV感染具有较高的自限性 ,长疗程低剂量口含α 干扰素对HGVRNA阴转无明显作用。Objective To evaluate the efficacy of long term and low dose α interferon in treatment of patients with chronic hepatitis C co infected with HGV.Methods 32 enrolled patients with chronic hepatitis C co infected with HGV were divided into two groups treated with α interferon or placebo.Serum ALT,HGV RNA and HCV RNA were determined before and 3 and 6 months after therapy.Results The ALT level of the α interferon group decreased steadly from the initial level of 119 6IU/L to 56 2IU/L at 6 month after treatment,significantly lower as compared with that of the placebo group(126IU/L).The HGV RNA negative seroconversion rates at 3 and 6 months after treatment were 64 7% and 64 7%,respectiely,as compared with 60 0% and 66 7% in the placebo group.No significant difference was found between the two groups.17 patients treated with α interferon were followed up for 6 months.The ALT maintained at high levels(154IU/L,168IU/L and 84IU/L,respectively)in the 3 patients with negative seroconversion of HGV RNA and persistent reactivity of HCV RNA.However,the ALT level returned to the normal(25IU/L,20IU/L and 20IU/L,respectively)in the 3 patients with persistent reactivity of HGV RNA and negative seroconversion of HCV RNA.HGV infection is self limited,and α interferon has no significant efficacy on the clearance of HGV RNA.The ALT level correlates with HCV RNA reactivity in serum,but not with HGV RNA.Conclusion HGV does not seem to cause the liver damage.

关 键 词：Α-干扰素 瘐型肝炎 临床流行病学 丙型肝炎 治疗 

分 类 号：R512.63[医药卫生—内科学] R978.7[医药卫生—临床医学]