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目的 观察干扰素α-2 b治疗慢性乙型肝炎 ( HBe Ag阳性或阴性 )的组织学及血清 HBVDNA的变化。方法 2 2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 Knode1 1计分法 ,免疫组织化学检测肝组织中 HBs Ag、HBc Ag表达。治疗前、治疗结束及治疗后随访 1 8周 ,双盲定量测定 HBV DNA ,同时检测 HBs Ag、HBc Ag及血清生化改变。结果 治疗结束时肝组织学中坏死及炎症程度与治疗前相比明显减轻 ( P<0 .0 1 ) ;55% ( 1 2 /2 2 )病人肝组织学活动指数得以改善。肝组织中HBc Ag转阴 1 1例。门脉炎症及纤维化程度无明显改善 ( P>0 .0 5)。无论 HBe Ag阳性或阴性 ,HBV DNA水平较治疗前明显下降 ( P<0 .0 1 )。治疗结束 HBe Ag阴转率为 4 2 .9%。 HBe Ag阳性与 HBe Ag阴性患者相比 ,其肝组织学损伤程度的改善及血清 HBV DNA的下降无明显区别。结论 干扰素α-2 b治疗慢性乙型肝炎 ( HBe Ag阳性或阴性 ) ,可明显降低血清 HBV DNA的水平 ,并明显改善其肝组织学的炎症及坏死程度。
Objective To observe the changes of histology and serum HBVDNA in patients with chronic hepatitis B (HBe Ag positive or negative) treated with interferon α-2b. Methods Twenty-two patients underwent liver biopsy within one week before treatment. Liver damage degree according to Knode1 1 scoring method, immunohistochemistry detection of liver tissue HBsAg, HBcAg expression. Before treatment, after treatment and after treatment for 18 weeks, double-blind quantitative determination of HBV DNA, simultaneous detection of HBsAg, HBcAg and serum biochemical changes. Results The degree of necrosis and inflammation in liver histology was significantly reduced at the end of treatment compared with those before treatment (P <0.01). The index of liver histology activity in 55% (12/2) patients was improved. HBc Ag in liver tissue negative 11 cases. Portal inflammation and fibrosis no significant improvement (P> 0.05). HBV DNA levels were significantly lower than before treatment regardless of HBe Ag positive or negative (P <0.01). At the end of treatment HBe Ag negative conversion rate was 42.2%. HBeAg-positive patients with HBeAg-negative compared to the improvement of the degree of liver damage and serum HBV DNA decreased no significant difference. Conclusion Interferon α-2b treatment of chronic hepatitis B (HBe Ag positive or negative), can significantly reduce the level of serum HBV DNA, and significantly improve the degree of liver inflammation and necrosis.