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目的探讨丙型肝炎患者肝组织中ＨＣＶＮＳ５和Ｆａｓ抗原表达及其与肝组织损伤和干扰素治疗反应的关系。方法应用α干扰素对一组慢性丙型肝炎患者进行２４周治疗，停药后随访６个月，以血清丙氨酸转氨酶（ＡＬＴ）恢复正常及血清ＨＣＶＲＮＡ持续阴转为完全应答标准，采用免疫组化方法检测组织中病毒和Ｆａｓ抗原表达状况。结果２９例慢性丙型肝炎患者肝组织中，ＨＣＶＮＳ５和Ｆａｓ抗原呈阳性者均为１９例（６５．５％），两者在肝组织中的表达显著相关；单因素相关分析时，两者均与组织病变程度有关，但多因素分析表明只有ＨＣＶＮＳ５抗原表达水平与组织炎症活动度呈正相关。治疗和随访结束时分别有１７例（５８．６％）和１５例（５１．７％）患者表现为近期和远期完全应答。治疗前Ｆａｓ表达水平与干扰素应答有关，但未见ＨＣＶＮＳ５水平与干扰素应答有明显关系；５例随访结束时重复肝穿，３例完全应答者病毒表达显著受抑，但Ｆａｓ抗原无明显改变，２例无应答者病毒表达无明显改变甚或增强，而Ｆａｓ表达均增强。结论慢性丙型肝炎肝组织中ＨＣＶＮＳ５表达在慢性丙型肝炎发病过程中有重要意义；Ｆａｓ抗原表达水平与组织中病毒表达相关；治疗前肝组织Ｆａｓ表达状况与干扰素治疗反应有一定联系?
Objective To investigate the expression of HCV NS5 and Fas antigen in the liver of patients with hepatitis C and their relationship with liver injury and response to interferon treatment. Methods A group of patients with chronic hepatitis C were treated with interferon-alpha for 24 weeks. The patients were followed up for 6 months after discontinuation of treatment. Serum levels of alanine aminotransferase (ALT) returned to normal and serum HCVRNA continued to be the standard of complete response. Immunization Histochemistry was used to detect the expression of virus and Fas antigen in tissues. Results Of 29 patients with chronic hepatitis C, HCV NS5 and Fas antigen were all positive in 19 cases (65.5%), both of which were significantly correlated in liver tissues. In the univariate correlation analysis, both And the degree of tissue lesions, but multivariate analysis showed that only the expression of HCV NS5 antigen and tissue inflammation activity was positively correlated. Seventeen patients (58.6%) and 15 patients (51.7%) at the end of treatment and follow-up, respectively, showed immediate and long-term complete response. The expression level of Fas in pre-treatment was related to the response to interferon, but no significant correlation was found between the level of HCV NS5 and the response to interferon. The recurrence of liver perfusion was observed in 5 patients at the end of follow-up. The expression of the virus was significantly inhibited in 3 responders but no significant change in Fas antigen , Two non-responders no significant change in the expression or even enhance the virus, and Fas expression were enhanced. Conclusion The expression of HCV NS5 in the liver of patients with chronic hepatitis C is important in the pathogenesis of chronic hepatitis C. The expression of Fas antigen is correlated with the expression of the virus in the tissues. There is a correlation between the expression of Fas in the liver and the response to interferon treatment before treatment.