基因重组干扰素治疗急性乙型肝炎疗效观察

目的　以基因重组干扰素治疗急性乙型肝炎病人，观察其减少急性乙肝转慢率的效果。方法　用基因重组α干扰素（３００ 万Ｕ，肌内注射，隔日１ 次，１２ 周为一个疗程） 治疗１９ 名急性乙肝病人，对治疗后未产生抗ＨＢｓ 者，加用乙肝疫苗（３０ μｇ，肌内注射，每周注射１ 次，连用３ 周）；对照组为病情相似的１５ 例病人，服用一般保肝药物。结果　治疗组１８ 例（９５－０％ ，１８１９）ＨＢｓＡｇ 阴转，但均未产生抗ＨＢｓ，再用乙肝疫苗后，１７ 例（９４－０％ ，１７１９） 产生抗ＨＢｓ。２４～２４０ 周随访期间，１８ 例ＨＢｓＡｇ 阴转者无复发；１ 例ＨＢｓＡｇ 未阴转者，至随访结束时仍为阳性。对照组８ 例（５３－０ ％ ，８１５）ＨＢｓＡｇ 阴转，同时，８７－５ ％（７８）的病例产生抗ＨＢｓ，另７ 例ＨＢｓＡｇ 未阴转者，在２４ ～２４０ 周的随访期间，仅１ 例ＨＢｓＡｇ阴转，余６ 例ＨＢｓＡｇ 持续阳性。结论　对于急性乙型肝炎发病８ 周后ＨＢｓＡｇ 仍未阴转者，采用干扰素合用乙肝疫苗，对防止转慢及ＨＢｓＡｇ 阴转后抗ＨＢｓ 的产生可能有一定作用

A report of recombinant interferon-alpha therapy in 19 patients with acute hepatitis B]

OBJECTIVE: In patients whose HBsAg are still positive after 8 weeks of acute hepatitis B attack, the chronic rate will increase. We try to treat them with IFN for reducing the rate of chronicity. METHODS: 19 patients were injected with rIFN-alpha 3 MU, q.o.d. for 12 weeks(treatment group), those who didn't have anti-HBs response after treatment were vaccinated with hepatitis B vaccine(30 micrograms, i.m., once weekly for 3 weeks); 15 patients received common therapy except rIFN-alpha(control group). RESULTS: HBsAg negative seroconversion rate was 95.0% (18/19) in treatment group and 53.0% (8/15) in control group(P < 0.05). No one responsed for anti-HBs in 18 HBsAg negatively converted patients in treatment group, but in control group 87.5% of HBsAg negatively converted patients developed anti-HBs (P < 0.001). Vaccinating the patients of treatment group, who didn't developed anti-HBs, with hepatitis B vaccine, 94.0% of them developed anti-HBs. After 24 to 240 week follow-up, no one relapsed in treatment group, in control group 8 HBsAg negative patients didn't replase, 6 out of 7 HBsAg positive patients were still positive at the termination and follow-up. CONCLUSION: The therapy with rIFN-alpha can reduce the chronic rate in the patients with acute HBV infection.