摘要
目的探讨抗ＨＢｅ／ＨＢＶＤＮＡ（＋）慢性乙型肝炎（ＣＨＢ）的干扰素治疗效果及其影响因素。方法对１５例ＨＢｅ（＋）和２５例ＨＢｅＡｇ（＋）ＣＨＢ患者用重组干扰素α－１ｂ治疗，治疗前、后和随访半年后检测ＨＢＶ及前Ｃ区Ａ１８９６终止变异。结果抗ＨＢｅ（＋）慢性乙型肝炎干扰素治疗近期应答率为７３％（１１／１５），与ＨＢｅＡｇ（＋）组比较差异无显著性（Ｐ＞００５）；治疗前抗ＨＢｅ（＋）组ＨＢＶＤＮＡ含量明显低于ＨＢｅＡｇ（＋）组（Ｐ＜０００５）；但前Ｃ区Ａ１８９６变异检出率４７％（７／１５）显著高于ＨＢｅＡｇ（＋）组的１６％（４／２５），Ｐ＜００５；４例复发者都是Ａ１８９６变异感染。结论血清ＨＢＶＤＮＡ水平可能是影响其应答的重要因素，前Ｃ区Ａ１８９６变异并不影响干扰素的近期应答率，但可能是其复发的一个重要因素。
Objective Anti-hepatitis B e and hepatitis B virus (HBV) DNA-positive chronic hepatitis B is clinically different from typical patients with hepatitis B e antigen(HBeAg)-positive. The response to recombinant interferon treatment and its influencing factors were analysed in the study. Methods Fifteen anti-HBe(+) and 25 HBeAg(+) patients with chronic hepatitis B received treatment of recombinant interferon-α-1b, at the dose of 3 MU intramuscularly three times a week for 6 months, the amount of HBV DNA and the precore A 1896 stop mutant in serum before treatment, at end of treatment and in a followup period of 6 months, were detected respectively by a quantitative polyermase chain reaction (PCR) assay of amplisensor and a misparing PCR combined with restricted fragment length polymorphism(RELP). Results The short-term response rate to interferon treatment in anti-HBe(+) patients with chronic hepatitis B was 73%(11/15), which was not significantly different from HBeAg-positive group (P>0 05), the amount of HBV DNA(4 8±1 5) before therapy in the anti-HBe-positive group was significantly lower than that in the HBeAg-positive group (5 9±0 8)(P<0 005), but 47%(7/15) of the detection rate of precore A1896 stop mutant in the anti-HBe-positive group was significantly higher than 16%(4/25) in the HBeAg-positive group (P<0 05), four cases of relapse in the anti-HBe(+) group were all infected with A1896 mutant. Conclusion The effect of recombinant interferon treatment in the anti-HBe(+) patients with chronic hepatitis B was similar to that of the HBeAg(+) patients, the level of HBV DNA in serum was an important factor of influencing interferon response. The mutant of precore A1896 may not influence the short-term response rate to interferon therapy, but it may be a key factor leading to relapse after therapy.
出处
《中华肝脏病杂志》
CAS
CSCD
1998年第4期218-220,共3页
Chinese Journal of Hepatology
基金
铁道部科技司资助
关键词
乙型肝炎
抗HBE
干扰素
疗效
影响因素
Hepatitis B Genic mutation Interferon Polymerase chain reaction
