干扰素和利巴韦林联合用药对慢性丙型肝炎患者肝组织中α-SMA、TIMP-1的影响

目的：探讨干扰素α-2b联合利巴韦林治疗慢性丙型肝炎，不同治疗效果组其肝组织中α-平滑肌肌动蛋白（α-SMA）、基质金属蛋白酶组织抑制因子-1(TIMP-1)的变化。方法：23例慢性丙型肝炎患者采用干扰素α-2b联合利巴韦林片治疗48周，据治疗结束和随访24周病毒学的结果分为持续病毒学应答（SVR）组和非SVR组。应用两步法对治疗前后肝组织中α-SMA及TIMP-1进行免疫组化染色,对其结果采用BI-2000免疫组化图像分析系统进行定量分析。结果：在SVR组，治疗后肝组织中的α-SMA及TIMP-1较治疗前明显下降(P＜0.05)；而在非SVR组，治疗后α-SMA及TIMP-1均较治疗前下降，但其差异无统计学意义(P均＞0.05)。在SVR组和非SVR组之间，α-SMA及TIMP-1表达的下降具有统计学意义（P＜0.05）。结论：干扰素α-2b联合利巴韦林治疗慢性丙型肝炎，可以通过降低α-SMA及TIMP-1的表达而具有抗纤维化的作用。获得SVR者其肝纤维化得到明显改善。

Changes of hepatic alpha-SMA and TIMP-1 induced by interferon-alpha-2b combined with ribavirin in patients with chronic hepatitis C

Objective： To investigate the changes of liver tissue inhibitors metalloproteinases-1(TIMP-1) and alpha-smooth muscle actin (α-SMA) induced by alpha-interferon-2b plus ribavirin therapy in patients with chronic hepatitis C. Methods： A total of 23 patients were enrolled in this study. All patients had received a 48-week interferon-alpha-2b plus ribavirin and had undergone virological follow-up for 24 weeks. In each patient, two liver biopsies had been performed: 1 week before treatment and 2 weeks after treatment. The patients were divided into two groups according to the viral response on 24 weeks after treatment: sustained viral response (SVR) group and non-SVR group. α-SMA and TIMP-1 in liver tissue were examined by immunohistochemical techniques and BI-2000 image-analysis system. Results： Posttreatment liver α-SMA and TIMP-1 were significantly lower than pretreatment scores(P＜0.05) in all patients. The groups between SVR and non-SVR were compatible in pretreatment results(P＞0.05). Posttreatment liver α-SMA and TIMP-1 were also significantly lower than pretreatment (P＜0.05) in SVR patients. But we did not found the same consequence in non-SVR patients(P＞0.05). There was a statistical difference between SVR and non-SVR patients in the changes of α-SMA and TIMP-1(P＜0.05). Conclusion： Interferon-alpha-2b plus ribavirin has the ability of anti-fibrosis by reducing the expression of liver α-SMA and TIMP-1. The liver fibrosis is improved significantly in patients receiving SVR, and no worsens in non-SVR patients.