慢性乙型肝炎患者行干扰素-α治疗初期的免疫应答:副反应和抗病毒疗效分析  

Initial immune response to interferon-α treatment in patients with chronichepatitis B:adverse effects and antiviral efficacy

作　　者：卜露 耿陶然[2] 冯晴 BU Lu;GENG Taoran;FENG Qing(School of Public Health,Nanjing Medical University,Nanjing 211112,China;Zhongda Hospital,Southeast University,Nanjing 210009,China)

机构地区：[1]南京医科大学公共卫生学院,江苏南京211112 [2]东南大学附属中大医院,江苏南京210009

出　　处：《东南大学学报（医学版）》2023年第6期879-885,共7页Journal of Southeast University(Medical Science Edition)

基　　金：国家自然科学基金资助项目(81902061)。

摘　　要：目的:对慢性乙型肝炎患者行干扰素-α治疗,研究治疗初期的抗病毒疗效和副反应之间的相互关系。方法:纳入95例接受干扰素-α治疗的慢性乙型肝炎患者,根据4周内的治疗情况,对治疗前后的实验室数据进行前后对照研究。结果:(1) 95例患者接受干扰素-α治疗4周内白细胞总数、中性粒细胞计数、丙氨酸转氨酶(ALT)水平、HBVDNA定量、乙型肝炎表面抗原(HBsAg)及乙型肝炎e抗原水平均明显降低(P<0.05)。(2)患者有乏力症状时,白细胞总数、中性粒细胞计数与无乏力症状时相比明显降低(P<0.001)。(3)治疗4周内血清ALT、天门冬氨酸氨基转移酶水平与消化道症状显著相关(P<0.01和P<0.001)。(4)治疗4周内HBV DNA差值与ALT差值呈线性正相关(P<0.05)。(5)治疗4周内HBsAg差值与血清ALT差值呈立方关系(P<0.01)。结论:治疗4周内,干扰素-α的副反应与免疫应答和抗病毒疗效均密切相关。Objective:To assess interferon-αtreatment in chronic hepatitis B infection(CHB),and to discover the relationship between the adverse effects and the antiviral efficacy in interferon-αtreatment initial phase.Methods:Ninety-five CHB patients with interferon-αtreatment were included.The parameters of blood cells,liver function,HBV loads,HBsAg and HBeAg were collected and compared within the initial 4 weeks in interferon-αtreatment.Results:(1)In 95 cases,leukocytes,neutrophils,ALT,HBV DNA,HBsAg,HBeAg were significantly decreased in 4 weeks after receiving interferon-αtreatment(P<0.05).(2)When patients had fatigue symptoms,the values of leukocytes and neutrophils were significantly decreased(P<0.001).(3)ALT,AST levels were highly related with gastrointestinal symptoms(P<0.01 and P<0.001).(4)The HBV DNA decline was associated with ALT decrease by a linear positive correlation(P<0.05).(5)HBsAg decline was associated with ALT decrease by a cube relationship(P<0.01).Conclusion:Within 4 weeks of interferon-αtreatment,the adverse effects of interferon-αare closely related with both the immune response and the antiviral efficacy.

关 键 词：慢性乙型肝炎 干扰素 副反应 抗病毒 疗效 

分 类 号：R512.62[医药卫生—内科学] R453[医药卫生—临床医学]