摘要
目的 总结干扰素治疗慢性乙型肝炎的临床指标变化特点,提出干扰素疗效预测的实用指标。 方法 采用前瞻性对照研究方法,将符合标准的150例患者随机分为治疗组(90例)和对照组(60例)通过治疗前内源性干扰素水平、用药后2,4个月末干扰素中和抗体等指标的测定,分析患者性别、年龄、治疗前丙氨酸氨基转移酶(ALT)水平及早期变化、HBV DNA定性定量、内源性干扰素水平、用药后2个月末干扰素中和抗体等指标的特点与HBeAg阴转的关系,提出干扰素疗效预测的实用指标。 结果 (1)不同年龄患者HBeAg阴转率差异不大,仅20～30岁与30～40岁年龄段差异有非常显著性(t>2.3312,P<0.01);(2)治疗前转氨酶水平明显升高者对干扰素反应好;与治疗前转氨酶水平相比,开始用药后第2个月末ALT下降幅度超过50％的患者最终HBeAg阴转率提高;(3)治疗前HBV DNA阴性或定量≤106/ml的患者,均有较高的HBeAg阴转率;(4)开始用药后第2个月末干扰素抗体阳性可作为HBeAg无应答的预测指标;(5)采用模糊数学综合评判的理论与方法提出了一个多因素联合预测方案,将其回代用于本组患者的疗效预测,敏感性为8 0％,准确性为90％,优越于单因素疗效预测。 结论 患者在干扰素治疗中临床指标的变化特点有别于西方患者;干扰素疗效与治疗前后转氨酶、HBV DNA水平及干?
Objective To summarize the clinical changing characters of the clinical markers after interferon treatment in chronic hepatitis B (CHB) and make out practical indexes to predict the effect. Methods 150 CHB patients were randomly divided into two groups: therapeutic group (90) and control group (60) in the prospective controlled trial. The levels of endogenous interferon before treatment, interferon antibody at the end of the second month and fourth month after treatment, alanine aminotransferase (ALT) and HBV DNA in the serum were detected. Then the data was analysed to find out indexes for predicting the effect. Results (1)The clearance rate of HBeAg had no significant difference in age except for 20-30 and 30-40 (t > 2.331 2, P < 0.01). (2)It was more effective if ALT level was higher than 400 U/L before treatment and it decreased more than 50% two months after treatment. (3)The patients whose HBV DNA was negative (dot hybridization) or less than 106 copies/ml before treatment had higher rate of HBeAg clearance. (4)There was no effect on patients whose interferon antibody turned positive at the end of the second month. (5)A predictive method of comprehensive factors was made out, whose sensitivity, specificity, and accuracy were 80%, 100% and 90%, respectively. Conclusion The clinical characters of these Chinese patients are different from those of the westerners and the effects of interferon have close relation to the levels of ALT, HBV DNA and interferon antibody.
出处
《中华肝脏病杂志》
CAS
CSCD
2003年第4期215-218,共4页
Chinese Journal of Hepatology
基金
深圳市科技局1998年度资助(199805007)
