Lapiński T W, Prokopowicz D
Kliniki Obserwacyjno-Zakaźnej Akademii Medycznej w Białymstoku.
Pol Merkur Lekarski. 1999 Jul;7(37):8-11.
Interferons are usage in therapy patients with chronic viral hepatitis (ch). Independently apart from therapy effects, lots of side effects are observed. The neuropsychiatrical side effects are most often and maybe hinder of interferon therapy. Among patients with ch B and C were estimated efficiency, type and frequency of side effects after interferon therapy. Especially symptoms disorders of central nervous system were observed between all side effects. The 67 patients: 20 with ch B, 45 with ch C and 2 with ch B retherapy by interferon were estimated. The lymphoblastoid interferon: alpha n1, Wellferon (Wellcome/Great Britain) and recombinant interferon alpha 2b, Roferon (Roche/Switzerland) and Intron-A (Schering-Plough/USA) were administrated. The efficiencies of treatment were observed after 6 month from finished interferon therapy. Elimination of polymerase HBV-DNA, antigens: HBs, HBe and antibody HBcIgM and normalization of aminotransferase activity in serum, were evaluated in patients with ch B. Elimination of HCV-RNA and normalization of aminotransferase activity in serum was evaluated in patients with ch C. Among neuropsychiatrical side effects was study. The frequently of irritability, fatigue neurosis, disorders of psychomotion activity, vegetative symptoms, somatic symptoms and disorder of higher mind processes. Grow excitability of sensorimotor, affective, irritability of vegetative system, were examined among irritability symptoms. Deficiency activity of polymerase HBV-DNA was observed in 40% patients with ch B. Deficiency of RNA-HCV in serum was observed in 31% patients with ch C. The flu-likely syndrome was observed at the beginning interferon therapy in 85% patients. Among patients treated with interferon were observed side effects: hair loss (29% patients), disorder of vision (29%), thrombocytopenia (< 50,000 mm3) (29%), leukopenia (< 2,000 mm3) (16%). The neurasthenia was detected in 60% patients with ch B and 50% patients with ch C. Neurasthenia most often manifested by irritable and quickly exhaustion of strength. 53% patients with ch B and 42% patients with ch C manifested disorders of psychomotion activity. Disorders of higher mind processes were in 50% patients with ch B and 33% with ch C. The neurological side effects were not influence on modification therapy. The flu-likely syndrome was observed at the beginning interferon therapy in majority patients treat with interferon. The neuropsychiatrical disorders are frequently watching of interferon therapy in patients with ch B and C.
干扰素用于慢性病毒性肝炎（CH）患者的治疗。除治疗效果外，还观察到许多副作用。神经精神方面的副作用最为常见，可能会阻碍干扰素治疗。对CH B和C患者进行了干扰素治疗后疗效、副作用类型及频率的评估。在所有副作用中，尤其观察到中枢神经系统症状紊乱。对67例患者进行了评估：20例CH B患者、45例CH C患者以及2例接受干扰素再治疗的CH B患者。使用了淋巴母细胞干扰素：α n1、Wellferon（英国威康公司）、重组干扰素α 2b、Roferon（瑞士罗氏公司）和Intron - A（美国先灵葆雅公司）。在干扰素治疗结束6个月后观察治疗效果。对CH B患者评估了乙肝病毒DNA聚合酶的清除、抗原：HBs、HBe以及抗体HBcIgM的情况，以及血清中转氨酶活性的正常化。对CH C患者评估了丙肝病毒RNA的清除以及血清中转氨酶活性的正常化。对神经精神方面的副作用进行了研究。包括易怒、疲劳性神经症、精神运动活动障碍、植物神经症状、躯体症状以及高级思维过程障碍的发生频率。在易怒症状中，检查了感觉运动兴奋性增加、情感性、植物神经系统易激惹性。40%的CH B患者观察到乙肝病毒DNA聚合酶活性缺乏。31%的CH C患者血清中观察到丙肝病毒RNA缺乏。85%的患者在干扰素治疗开始时出现类似流感的综合征。在接受干扰素治疗的患者中观察到的副作用有：脱发（29%的患者）、视力障碍（29%）、血小板减少（<50,000/mm³）（29%）、白细胞减少（<2,000/mm³）（16%）。60%的CH B患者和50%的CH C患者检测到神经衰弱。神经衰弱最常表现为易怒和体力迅速耗尽。53%的CH B患者和42%的CH C患者表现出精神运动活动障碍。50%的CH B患者和33%的CH C患者出现高级思维过程障碍。神经方面的副作用不影响治疗方案的调整。大多数接受干扰素治疗的患者在治疗开始时出现类似流感的综合征。神经精神障碍在CH B和C患者的干扰素治疗中很常见。
