干扰素治疗慢性丙型肝炎中疗效预测因素的研究  

Study on the therapeutic predicted factor of interferon therapy in chronic hepatitis C

作　　者：白菡[1] 王者虹[2] 丁洋[1] 王玉梅[1] 张琳[1] 冯国和[1] 黄芬[1] 赵桂珍[1] 李颖[1] 安萍[1] 吴长君[2] 

机构地区：[1]中国医科大学附属第二医院感染科,沈阳110004 [2]鞍钢曙光医院感染科

出　　处：《中国冶金工业医学杂志》2004年第1期9-11,共3页Chinese Medical Journal of Metallurgical industry

摘　　要：目的 :通过检测干扰素抗体、HCV基因分型、治疗前后血清HCV -RNA量及淋巴细胞亚群 ,探讨干扰素疗效的预测因素。方法 :ELISA方法检测干扰素抗体 ,抗病毒中和生物鉴定法进行干扰素中和抗体检测。用MTT检测干扰素中和抗体的滴度。进行HCV基因分型及血清HCV -RNA定量检测。采用APAAP免疫桥联酶标法检测T淋巴细胞亚群。结果 :(1 )HCV -Ⅲ型感染者完全应答率较HCV -Ⅱ型高 ,P<0 0 5。 (2 )完全应答组治疗前血清HCV -RNA量明显低于部分应答和无应答组。 (3)部分应答组干扰素抗体阳性率明显高于完全应答组 ,P<0 0 5。中和抗体对干扰素疗效的影响与抗体的滴度有关 ,抗体滴度高干扰素疗效差。 (4)各组间淋巴细胞亚群变化无统计学差异。结论 :(1 )治疗前血清HCV -RNA低水平是对干扰素治疗产生完全应答的一个重要的预测指标。 (2 )HCV -Ⅲ型患者对干扰素治疗的完全应答率明显高于HCV -Ⅱ型。但可能受血清HCV -RNA水平的影响。 (3)干扰素抗体 ,特别是中和抗体是影响干扰素疗效的因素之一 ,治疗过程中检测干扰素抗体是预测干扰素疗效的指标之一。 (4)外周血淋巴细胞亚群不能作为预测干扰素疗效的指标。Objective:To find the therapeutic predicted factor of interferon(IF)therapy in chronic hepatitis C by detection of IF antibodies,HCV genotype,quantity of HCV-RNA,and T lymphocyte subgroup.Methods:IF antibodies were detected by ELISA,and neutralizing antibodies were detected by antiviral neutralizing bioassay,genotype of HCV and quantity of HCV-RNA were detected;T lymphocyte subgroup were detected by APAAP immuno-enzyme assay.Results:(1)HCV-genotype Ⅲ has higher complete response rate than HCV-genotype Ⅱ.(2)The quantity of HCV-RNA in group of complete response is lower than goupe of partial response and non-response.(3)The positive rate of IF antibodies in partial response group in higher than complete response group.The titer of the antibodies is related to the therapeutic effect.(4)There are no difference of T lymphocyte subgroup between each groups.Conclusions:(1)Lower HCV-RNA before therapy is an important predicted index for complete response.(2)HCV-Ⅲ has higher response to IF than HCV-Ⅱ,but may be also related to the quantity of HCV.(3)IF antibodies,especially neutralizing antibodies can affect the therapeutic effect.(4) T lymphocyte subgroup cant be a predicted index.

关 键 词：干扰素 药物治疗 慢性丙型肝炎 疗效 预测因素 淋巴细胞亚群 检测 抗体 

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