影响干扰素治疗慢性乙型肝炎疗效的因素探讨

目的探讨肝组织病理学变化、乙型肝炎病毒DNA（HBVDNA）水平、谷丙转氨酶（ALT）水平对慢性乙型肝炎患者干扰素抗病毒治疗疗效的影响。方法对97例适合抗HBV治疗的慢性乙型肝炎患者应用α-1b干扰素治疗24周，治疗前后对ALT、HBVDNA、HBeAg／HBeAb水平进行检测、分析，其中32例患者在治疗前行肝活检明确肝组织炎症活动情况。结果肝组织炎症活动度较高者抗HBV治疗后HBVDNA转阴率和HBeAg血清转换率较高，而治疗前ALT水平对治疗后HBVDNA转阴率和HBeAg血清转换率影响较小；基线HBVDNA水平在10^5～10^6 copies／ml的患者治疗后HBVDNA转阴率和HBeAg血清转换率较高。结论抗病毒前肝组织炎症活动程度明显者、HBVDNA水平在10^5-10^6copies／ml者干扰素抗HBV疗效较好。

Investigation of influence factors on the efficacy of interferon-α-1b therapy in patients with chronic hepatitis B

Objective To investigate the influence factors on the efficacy of interferon-α-1b therapy in patients with chronic hepatitis B. Methods We treated 97 CHB patients with α-1bIFN for six months,and their ALT levels, HBV DNA and HBeAg/HBeAb seroconversion after the therapy were determined. 32 patients were made liver histopathological biopsy. Results The negativity of HBV DNA and HBeAg/HBeAb seroconversion rates were higher in patients with evident inflammatory activities in liver,but the baseline ALT levels was not positively correlated to the response rates. The negativity of HBV DNA and HBeAg/HBeAb seroconversion rates were higher in patients with HBV DNA levels between 10^5- 10^6 copies/ml. Conclusion The anti-HBV therapy effects with a-1bIFN are better in CHB patients with higher inflammatory activities in liver and low HBV DNA levels in sera.