论文部分内容阅读
目的 观察干扰素α－ ２ｂ治疗 １８周后的慢性乙型肝炎患者肝组织学及血清 ＨＢＶ ＤＮＡ等变化。方法采用肝组织损伤程度Ｋｎｏｄｅｌｌ计分法、免疫组织化学及血清ＨＢＶ ＤＮＡ定量检测对２２例患者治疗前后进行比较。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＜０．０１）；５５％（１２／２２）患者肝组织学活动指数得以改善，其中门静脉炎症及纤维化程度无明显改善（Ｐ＞０．０５）。免疫组织化学检测显示治疗后肝组织中 ＨＢｅＡｇ阴转率为 ５３．８％（７／１３），活化的星状细胞数显著减少（ Ｐ＝ ０．０００４）。血清 ＨＢＶ ＤＮＡ水平较治疗前明显下降（Ｐ＜ ０．０１）。治疗结束 ＨＢｅＡｇ阴转率为 ４２．９％（６／１４）。 ＨＢｅＡｇ阳性与 ＨＢｅＡｇ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－２ｂ治疗慢性乙型肝炎可明显降低血清ＨＢＶ ＤＮＡ的水平，并改善其肝组织学的炎症及坏死程度。
Objective To observe the changes of liver histology and serum HBV DNA in patients with chronic hepatitis B after interferon α-2b treatment for 18 weeks. Methods The degree of liver injury Knodell scoring method, immunohistochemistry and serum HBV DNA quantitative detection of 22 patients before and after treatment were compared. Results At the end of treatment, the degree of necrosis and inflammation in liver histology was significantly reduced compared with those before treatment (P <0.01). The hepatic histological activity index of 55% (12/22) patients was improved, including portal vein inflammation and fibrosis No significant improvement (P> 0.05). Immunohistochemistry showed that the negative rate of HBeAg in liver tissue was 53.8% (7/13) and the number of activated stellate cells was significantly decreased (P = 0.0004). Serum HBV DNA levels were significantly lower than before treatment (P <0.01). At the end of treatment, HBeAg negative conversion rate was 42.9% (6/14). HBeAg-positive HBeAg-negative patients 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 can significantly reduce the level of serum HBV DNA, and improve the degree of liver inflammation and necrosis.