摘要
目的:比较用聚乙二醇干扰素(pegasys)和拉米夫定治疗慢性乙型肝炎患者前后的肝组织病理变化。方法:对20例患者随机分为两组,pegasys组(n=12)和拉米夫定组(n=8)。第1次肝穿刺活检后,12例患者使用pegasys 180μg,1次/周皮下注射;8例患者使用拉米夫定100 mg,1次/d;分别连续用药48周。停药观察24周后,第2次肝穿,对治疗前后的肝活检组织进行炎症和纤维化分级及积分。结果:两组治疗后的肝组织炎症和坏死积分均较治疗前有降低,其中pegasys组点状融合坏死治疗前后有显著差异(t=2.56,P<0.05),拉米夫定组门脉周围坏死治疗前后比较有显著差别(t=2.56,P<0.05);两组的纤维化积分无变化。持续血清学应答患者治疗前后肝组织在HAI积分、汇管区周围坏死、点状融合坏死和汇管区炎症等方面有显著性差异(P<0.05),而纤维化积分无差异。结论:两种抗病毒药物均能有效改善慢性乙型肝炎患者的肝脏组织学状况,但对已经发生的肝纤维化无明显改善。
Objective：To compare the pathological changes of liver before and after treatment with pegasys and lamivudine in patients with hepatitis B. Methods： Twelve hepatitis B patients were given pegasys 180/μg 1/w （s.c.） and 8 were given lamivudine 100mg 1/d （p.o.） for 48 weeks after the first biopsy. Second biopsy was done 24 weeks after withdrawal of treatment. The inflammation and fibrosis were graded and scored before and after treatment, Results： The scores of inflammation and necrosis were decreased after treatment with both drugs. There was significant difference in focal necrosis before and after treatment with Pegasys （P〈0.05） and in periportal necrosis before and after treatment with lamivudine （P〈0.05）. No changes were found in the fibrosis scores after treatment with both drugs. There were significant changes in the scores of HAl, periportal necrosis, focal necrosis and portal inflammation in patients with sustained serum viral responses（P〈0.05）, and no significant changes of fibrosis score were observed. Conclusion： Both drugs can improve the histology of the liver in hepatitis B patients, hut have not obvious effect on the existed fibrosis.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2005年第9期1043-1045,共3页
Academic Journal of Second Military Medical University
基金
罗氏长效干扰素国际多中心临床试验课题基金(WW16240
WW16241)
