【摘要】 目的　观察干扰素α-2 b治疗慢性乙型肝炎 ( HBe Ag阳性或阴性 )的组织学及血清 HBVDNA的变化。方法　 2 2例病人治疗前、治疗结束 1周内行肝穿刺活检。肝组织损伤程度按 Knode1 1计分法 ,免疫组织化学检测肝组织中 HBs Ag、HBc Ag表达。治疗前、治疗结束及治疗后随访 1 8周 ,双盲定量测定 HBV DNA ,同时检测 HBs Ag、HBc Ag及血清生化改变。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 .0 1 ) ;55% ( 1 2 /2 2 )病人肝组织学活动指数得以改善。肝组织中HBc Ag转阴 1 1例。门脉炎症及纤维化程度无明显改善 ( P>0 .0 5)。无论 HBe Ag阳性或阴性 ,HBV DNA水平较治疗前明显下降 ( P<0 .0 1 )。治疗结束 HBe Ag阴转率为 4 2 .9%。 HBe Ag阳性与 HBe Ag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-2 b治疗慢性乙型肝炎 ( HBe Ag阳性或阴性 ) ,可明显降低血清 HBV DNA的水平 ,并明显改善其肝组织学的炎症及坏死程度。更多还原

【Abstract】 Objective To investigate the liver histological changes and serum HBV DNA changes induced by interferon α 2b or therapy for 18 weeks in patients with e antigen positive or negative chronic hepatitis B infection Methods Twenty two patients were enrolled in this study All patients had a liver biopsy within a week before starting interferon therapy Interferon α 2b was given at a dose of 3Mu thrice a week for 18 weeks A second liver biopsy was taken for comparison at the end of week 18 Blinded biopsies were scored according to Knode11’s histology activity index (HAI), and HBsAg and HBcAg were examined with immunohistochemistry method The serum samples corresponding with liver biopsies were collected and HBV DNA,e antigen, s antigen and biochemical markers were measured, Results Histological assessment revealed a significant improvement in intralobular inflammation and periportal +/ bridging necrosis after treatment(P<0 01) Fifty five percent (12/22)patients had a reduction of hepatic necroinflammatory HAI score by≥2 points at the end of 18 weeks of interferon α 2b therapy compared to pre treatment values HBcAg disappearance from liver tissues was seen in 11 cases Serum HBV DNA levels decreased significantly during treatment (P<0 01) The clearance rate of HBeAg was 42 9% after treatment There was no significant difference between HBeAg positive and negative patients either in liver histological improvements or declining level of serum HBV DNA Conclusions Interferon α 2b may decrease the level of serum HBV DNA in e antigen positive or negative patients with chronic hepatitis B infection, and improve their necroinflammation in liver tissue更多还原