摘要
评价国产干扰素α 2b治疗慢性乙型肝炎后肝脏组织学和病毒抗原表达的变化。方法 14例病人治疗前、治疗结束 1周内行肝穿刺活检。肝组织损伤程度按Knodell计分法 ,肝组织中HBV抗原 (包括HBsAg、HBcAg)表达用半定量免疫组织化学记分法测定。治疗前、治疗结束与肝活检同期取血 ,检测HBsAg、HBcAg及血清生化 ,双盲定量测定HBVDNA。结果 治疗结束时 ,肝组织学活动指数降低 (P <0 .0 5 ) ,尤其坏死及小叶内炎症程度与治疗前相比明显减轻 (P均 <0 .0 1) ;PCR定量分析显示血清HBVDNA明显下降 (P <0 .0 1) ;血清HBeAg、HBVDNA(斑点杂交 )均有 7例转阴 ,伴随血清定量HBVDNA下降 ,与肝组织学改善相关。门脉炎症及纤维化程度无明显改善 (P >0 .0 5 )。治疗结束时 10例病人肝组织中HBcAg转阴 ,尤其对干扰素应答组治疗前后差异显著 (P <0 .0 1)。结论 干扰素α 2b治疗慢性乙型肝炎 ,可改善其组织学状况 ,减轻肝损伤 ;
Objective To evaluate the effect of interferon alpha 2b treatment on histological changes and viral antigen expression in liver biopsies of chronic hepatitis B patients.Methods Fourteen patients were enrolled into this open label study. All patients had liver biopsy within 1 week before and after treatment. Histological changes were assessed using Knodell's histologic activity index(HAI). HBV antigens including HBsAg and HBcAg were evaluated using a semi quantitative immunohistochemical scoring system. The serum samples corresponding with liver biopsies were collected and HBV DNA, e antigen, s antigen and biochemical markers were measured.Results Histological assessment revealed a significant decrease in the HAI score, especially in the intralobular inflammation and periportal +/- bridging necrosis after treatment ( P <0.01). Serologic response with clearance of HBeAg in 7 patients and reduction of HBV DNA were associated with this improvement. The scores of fibrosis and portal inflammation, however, did not show any difference. HBcAg expression showed a significant decrease after treatment, and its disappearance rate was 71.4%.Conclusion Interferon alpha 2b therapy can improve the hepatic histology with reduction in hepatocytic injury. The serologic response is due to decrease of HBV replication in the hepatocytes.
出处
《肝脏》
2000年第2期84-86,共3页
Chinese Hepatology
