儿童慢性乙型肝炎免疫耐受期研究进展  

Progress in study on immune -tolerant children with chronic hepatitis B

作　　者：朱世殊[1] 董漪[1] Zhu Shishu;Dong Yi(Pediatric Liver Diseases Therapy and Research Center,302 Military Hospital of China,Beifing 100039,China)

机构地区：[1]中国人民解放军第三0二医院青少年肝病诊疗与研究中心,北京100039

出　　处：《中华实用儿科临床杂志》2018年第22期1686-1689,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：“首都临床特色应用研究”专项基金（Z141100002114032）

摘　　要：慢性乙型肝炎的自然史较复杂，包括4期：免疫耐受期、免疫清除期、免疫控制期和免疫逃逸期，其中免疫耐受期因其免疫特征不完全清楚，致其定义至今不能达成共识。目前诊断标准要求丙氨酸转氨酶正常，乙型肝炎s、e抗原阳性，乙型肝炎病毒DNA高载量和肝组织学炎症轻微或正常。各指南目前均不推荐此期抗病毒治疗，但近年来有几项儿童乙型肝炎免疫耐受期抗病毒治疗的研究取得了一定的疗效。在没有足够的循证医学证据之前，对于免疫耐受期的患儿建议严密和规律地监测丙氨酸转氨酶和乙型肝炎病毒DNA载量，以便及时发现是否已进入免疫清除期。The natural history of chronic hepatitis B is complex including immune - tolerant phase, inmmne clearance phase,inactive carrier phase and reactivation phase, among these phases,it has not yet reached a consensus on the definition of the immune - tolerant phase, because its key immune features are not entirely sure. However, the current diagnostic criteria of this phase require normal alanine aminotransferase （ALT） levels, positive hepatitis B s an- tigen and e antigen, high serum hepatitis B virus DNA （ HBV - DNA ） , and slight or normal inflammation of liver histolo- gy. Antiviral therapy in this phase is currently not recommended in all guidelines, but in recent years, antiviral treatment of immune - tolerant children achieved efficacy in several study. Nonetheless before new findings are published,it would be important to closely and regular monitor serum ALT and HBV - DNA in the immune - tolerant children.

关 键 词：慢性乙型肝炎 免疫耐受期 儿童 抗病毒治疗 监测 

分 类 号：R725.1[医药卫生—儿科]