IFN-α治疗慢性乙型肝炎的效果及其影响因素

目的分析干扰素-α（IFN-α）治疗慢性乙型肝炎（CHB）效果的影响因素。方法选择2006—2009年青岛市传染病医院住院的CHB病人46例,应用IFN-α治疗48周,根据IFN-α疗效将其分为应答组与无应答组,评价病人的宿主、病毒载量及生化指标等因素对疗效的影响。结果两组的性别比例、年龄和病程比较差异无显著性（P〉0.05）;应答组治疗前HBV-DNA载量显著低于无应答组,ALT水平显著高于无应答组（t=2.381、2.800,P〈0.05）;HBeAg阳性病人的应答率显著高于HBeAg阴性病人（χ2=4.193,P〈0.05）;应答组在治疗12周时HBV-DNA载量下降〉2 log的比例显著高于无应答组（χ2=4.278,P〈0.05）。结论治疗前HBV-DNA载量低、ALT水平高和HBeAg阳性以及治疗12周时HBV-DNA应答情况可以作为IFN-α治疗CHB病人48周时应答的预测因素。

EFFECT OF INTERFERON-ALPHA IN THERAPY OF CHRONIC HEPATITIS B AND ITS INFLUENCING FACTORS

Objective To analyze the influencing factors of the effect of interferon-alpha（IFN-α） in the treatment of chronic hepatitis B（CHB）. Methods Forty-six CHB patients,who were hospitalized in Qingdao Hospital of Infectious Diseases from January 2006 to June 2009,were selected in this study.All of them received IFN-α treatment for 48 weeks and were divided into response group and non-response group based on the efficacy of IFN-α treatment.The influence of host factors,viral loads and biochemical indicators on the curative effect was assessed. Results No differences were found in the proportion of sex,age and course of the disease between response and non-response groups（P〉0.05）.Before therapy,the HBV-DNA loads were lower in response group than that in the non-response,and the ALT level was higher（t=2.381,2.800;P〈0.05）.The response rate of HBeAg positive patients was higher than that of the HBeAg negative（χ2=4.193,P〈0.05）.At week 12 of treatment,the loads of HBV-DNA dropped more than 2 log in the response group,which was significantly higher than that in the non-response（χ2=4.278,P〈0.05）. Conclusion The low HBV-DNA load,high ALT level and positive HBeAg before treatment,as well as HBV-DNA response at week-12 of treatment can be used as predictive factors for response in CHB patients at 48th week of treatment.