干扰素-γ抗肝纤维化组织学疗效及其对HBV复制的影响  

Effects of interferon gamma on liver fibrosis and hepatitis B virus replication

作　　者：张复春[1] 冼建中[1] 曹阳[1] 吴婉芬[1] 

机构地区：[1]广东省广州市第八人民医院,510060

出　　处：《广东医学》2003年第3期253-254,共2页Guangdong Medical Journal

摘　　要：目的　观察干扰素 (IFN) -γ治疗慢性乙型肝炎 (CHB)肝纤维化的疗效及其对HBV复制的影响。方法　采用开放、随机、肝纤维化半定量计分等方法 ,对 60例CHB患者进行治疗前后肝组织学、血清肝纤维化指标及HBVDNA水平比较。结果　治疗 9个月后肝纤维化计分从治疗前的 13 4± 5 4下降到治疗后的 10 2± 5 3 ,与对照组比较差异非常显著 (P <0 0 0 1) ;透明质酸 (HA)、Ⅳ型胶原 (CⅣ )、Ⅲ型前胶原 (PCⅢ )、层黏蛋白 (LN)分别为 ( 165 2± 98 4)ng/ml、( 13 6 3± 5 8 9) μg/ml、( 187 6± 42 3 ) μg/ml、( 15 8 4± 10 8 6)ng/ml ,与治疗前及对照组比较 ,差异有显著性 (P均 <0 0 0 1) ;血清HBVDNA水平 ( 10 5.8± 3 .6copies/ml)较治疗前 ( 10 7.6± 3 .4copies/ml)显著下降 (P <0 0 1)。结论　IFN -γ治疗CHB肝纤维化具有较好疗效 。Objective To study the effects of interferon on liver fibrosis and hepatitis B virus(HBV) replication. Methods Sixty patients with chronic Hepatitis B were randomly divided into therapy group and control group. Patients in therapy group received interferon gamma for nine months. All patients had a liver biopsy within 1 week before starting interferon therapy. A second liver biopsy was taken for comparison in 30 cases at the end of therapy. Biopsy samples were scored blindly according to a semiquantitative scoring system(SSS). The serum fibrosis markers and HBV DNA levels were measured. Results The score of fibrosis had a significant reduction from 13 4±5 4 before treatment to 10 2±5 3 after treatment, significantly lower than that in control group( P <0 001). At the end of treatment, the levels of serum hyaluronic acid(165 2±98 4 ng/ml), type Ⅳ collagen(136 3±58 9 μg/ml), type Ⅲ procollagen(187 6±42 3 μg/ml) and laminin(158 4±108 6 ng/ml) were significantly lower than that before treatment and that in control group. Serum HBV DNA levels(10 5.8±3.6 copies/ml) were significantly lower after treatment than that (10 7.6±3.4 copies/ml)before treatment( P <0 01). Conclusion This study indicates that interferon gamma has the effect of antifibrosis in patients with chronic hepatitis B, and may inhibit replication of HBV.

关 键 词：干扰素-Γ 抗肝纤维化 组织学疗效 HBV 

分 类 号：R575.2[医药卫生—消化系统]