慢性乙型肝炎患者行干扰素-α治疗初期的免疫应答:副反应和抗病毒疗效分析-东南大学学报医学版

慢性乙型肝炎患者行干扰素-α治疗初期的免疫应答:副反应和抗病毒疗效分析

单位：1. 南京医科大学公共卫生学院, 江苏南京 211112;
2. 东南大学附属中大医院, 江苏南京 210009

分类号：R512.62; R453

出版年·卷·期（页码）：2023·42·第六期（879-885）

摘要：

目的:对慢性乙型肝炎患者行干扰素-α治疗,研究治疗初期的抗病毒疗效和副反应之间的相互关系。方法:纳入95例接受干扰素-α治疗的慢性乙型肝炎患者,根据4周内的治疗情况,对治疗前后的实验室数据进行前后对照研究。结果:(1) 95例患者接受干扰素-α治疗4周内白细胞总数、中性粒细胞计数、丙氨酸转氨酶(ALT)水平、HBVDNA定量、乙型肝炎表面抗原(HBsAg)及乙型肝炎e抗原水平均明显降低(P<0.05)。(2) 患者有乏力症状时,白细胞总数、中性粒细胞计数与无乏力症状时相比明显降低(P<0.001)。(3) 治疗4周内血清ALT、天门冬氨酸氨基转移酶水平与消化道症状显著相关(P<0.01和P<0.001)。(4) 治疗4周内HBV DNA差值与ALT差值呈线性正相关(P<0.05)。(5) 治疗4周内HBsAg差值与血清ALT差值呈立方关系(P<0.01)。结论:治疗4周内,干扰素-α的副反应与免疫应答和抗病毒疗效均密切相关。

Objective: To assess interferon-α treatment in chronic hepatitis B infection(CHB), and to discover the relationship between the adverse effects and the antiviral efficacy in interferon-α treatment initial phase. Methods: Ninety-five CHB patients with interferon-α treatment were included. The parameters of blood cells, liver function, HBV loads, HBsAg and HBeAg were collected and compared within the initial 4 weeks in interferon-α treatment. Results: (1) In 95 cases, leukocytes, neutrophils, ALT, HBV DNA, HBsAg,HBeAg were significantly decreased in 4 weeks after receiving interferon-α treatment(P<0.05).(2) When patients had fatigue symptoms, the values of leukocytes and neutrophils were significantly decreased(P<0.001).(3) ALT, AST levels were highly related with gastrointestinal symptoms(P<0.01 and P<0.001).(4) The HBV DNA decline was associated with ALT decrease by a linear positive correlation(P<0.05).(5) HBsAg decline was associated with ALT decrease by a cube relationship(P<0.01). Conclusion: Within 4 weeks of interferon-α treatment, the adverse effects of interferon-α are closely related with both the immune response and the antiviral efficacy.

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