摘要
目的 再评价干扰素（IFN）治疗HBeAg阳性慢性乙型肝炎（CHB）患者的疗效,探索预测其疗效的相关因素.方法 严格按入选标准选择HBeAg阳性CHB患者,以常规IFN 500～600万单位治疗,据随访结果及患者依从性、药物不良反应等确定疗程和调整治疗方案.结果 完成疗程者206例,128例（62.1%）在治疗结束前达到了eAg-eAb血清学转换.其中16～25岁者优于26～35岁者,非母婴垂直传播者优于可疑母婴垂直传播者;谷丙转氨酶（ALT）在治疗前5～10倍正常值上限（ULN）者,治疗早期（前3个月）较基线升高大于或等于5倍者,治疗6个月降至正常者对IFN反应更好;HBV-DNA定量在治疗前低水平者,治疗早期（前3个月）下降大于2个对数级者有更高的eAg-eAb血清学转换率.结论 ALT、HBV-DNA在治疗前的水平及治疗中的变化对IFN疗效有较好预测作用.
Objective To re-evaluate the effect of conventional interferon on HBeAg-positive chronic hepatitis B （CHB） patients,and investigate Jche probable predictive factors related to the response to interferon therapy. Methods HBeAg-positive CHB patients with elevated ALT were treated with conventional interferon with the dosages of 50--60μg. The duration and strategy were adjusted according to the patients＇ response to the therapy,compliance of the patients and side effects of interferon. Results 128 cases in 206 patients got eAg-eAb serum conversion at the end of treatment with a conversion rate 62.1%. Patients of 16--25 years old had a higher conversion rate than patients of 26--35 years old, and also patients with vertical transmission had a higher transmission rate. The conversion rate of eAg-eAb for patients with ALT 5-10 ULN was higher than with 2-5ULN before treat- ment. Patients with ALT level more than 5ULN elevation in the early three months had a higher conversion rate than less than 5ULN elevation patients. Patients whose liver function returned to normal during 6 months interferon therapy had a conversion rates of 70.2% ,better than patients with a fluctuation liver function（50.6%）i Patients with HBV-DNA quantity less than 1.0 × 10^6 copies/mL had a higher eAg-eAb serum conversion rate than with 1.0 ×10^8 -- 1.0 × 10^8 copies/mL. Patients with HBV-DNA level reduction by more than 2logs in the early phase after 3 months treatment had higher conversion rate than less than 2logs pa tients,and there were statistic differences between the related groups. Conelusion ALT level and HBV-DNA load are good predictive factors for IFN response before and duing treatment.
出处
《重庆医学》
CAS
CSCD
北大核心
2011年第12期1147-1149,共3页
Chongqing medicine
基金
国家自然科学基金资助项目(30100158)
重庆市渝中区科委基金资助项目(2007-2009)
重庆市科委自然科学基金计划资助项目(CSTC
2009BB5063)
重庆市教委基金资助项目(KJ070317)
关键词
肝炎
乙型
慢性
干扰素
抗病毒治疗
影响因素
hepatitis B, chronic
interferon
antiviral therapy
influencing factors
