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目的对于PEG-干扰素α-2a(PEG-IFNα-2a)治疗的低转氨酶水平慢性乙型肝炎患者进行回顾性研究。方法对治疗满48周并于治疗前完成肝活检的乙型肝炎患者,取用药后第12周、24周、48周为观察点,记录乙型肝炎病毒血清标志物与HBV DNA的变化情况,并分析其应答与肝组织炎症程度(G分级)、肝细胞HBcAg分布的相关程度。结果按炎症级别分组之HBeAg阳性组:治疗48周时G1组总有效率20%(2/10),G2组总有效率56.25%(9/16),G3组100%(6/6);HBeAg阴性组炎症级别G1组10%(1/10),G2组62.5%(5/8),G3组100%(2/2)。按照肝细胞HBcAg表达分组之HBeAg阳性组:48周时浆型表达总有效率80%(8/10),混合型表达组总有效率42.1%(8/19),阴性表达组100%(3/3)。HBeAg阴性组:浆型分布组DNA阴转率为37.5%(3/8),混合型组为28.57%(2/7),阴性组为60%。结论无论按照炎症还是肝细胞HBcAg表达分组比较,最初统计学处理后发现各个级别分组所得数据未见明显差异(包括HBeAg阳性与阴性组)。加入时间因素后显示随时间延长,高炎症水平、HBcAg的阴性表达和(或)浆型表达会有更高的疗效。
Objective To retrospectively study patients with chronic hepatitis B with low transaminase level treated with PEG-IFNα-2a. Methods Hepatitis B patients who were treated for 48 weeks and completed liver biopsy before treatment were taken as observation points at the 12th, 24th and 48th week after treatment. The changes of hepatitis B virus (HBV) serum markers and HBV DNA were recorded. And analyzed the correlation between the response and the degree of liver inflammation (G grade), hepatocellular HBcAg distribution. Results The HBeAg positive groups were grouped according to the inflammation grade: the total effective rate was 20% (2/10) in G1 group, 56.25% (9/16) in G2 group, and 100% (6/6) in G3 group. The HBeAg-negative group had 10% (1/10) in the G1 group, 62.5% (5/8) in the G2 group and 100% (2/2) in the G3 group. According to the HBeAg positive group of HBcAg expression group, the total effective rate was 80% (8/10) in the 48 weeks, 42.1% (8/19) in the mixed expression group and 100% (3) in the negative expression group / 3). HBeAg-negative group: plasma distribution group DNA negative conversion rate was 37.5% (3/8), mixed group was 28.57% (2/7), the negative group was 60%. Conclusion No statistically significant differences (including HBeAg positive or negative) were found in the data of all levels after initial statistical analysis, both in terms of inflammation and hepatocyte HBcAg expression. The addition of a time factor showed a higher efficacy over time, a higher level of inflammation, a negative expression of HBcAg and / or a positive expression of plasma.