Arase Yasuji, Ikeda Kenji, Suzuki Yoshiyuki, Kobayashi Masahiro, Suzuki Fumitaka, Akuta Norio, Sezaki Hitomi, Hosaka Tetsuya, Yatsuji Hiromi, Kawamura Yusuke, Kobayashi Mariko, Kumada Hiromitsu
Department of Hepatology, Toranomon Hospital, Tokyo.
Intern Med. 2007;46(15):1155-60. doi: 10.2169/internalmedicine.46.0150. Epub 2007 Aug 2.
The aim of this study was to evaluate whether or not combination therapy of pegylated interferon (IFN) and ribavirin for chronic hepatitis (CH) C patients enhances the serum level of KL-6, a sensitive marker for interstitial pneumonia.
CH C patients proven histologically and treated with combination therapy of pegylated IFN-alpha-2b and ribavirin, IFN monotherapy or untreated for 48 weeks were retrospectively selected in chronological order in groups of 25. Serum levels of KL-6 were measured by enzyme-linked immunosorbent assay by use of serum stored at -80 degrees C before and at 12, 24, 36, 48 weeks after the initiation of treatment or follow up.
The average serum KL-6 levels in patients treated with combination therapy of pegylated IFN and ribavirin increased by 21% at 12 weeks after the start, 23% at 24 weeks, and 28% at 48 weeks. In patients treated with combination therapy of pegylated IFN and ribavirin, the serum KL-6 level significantly increased during treatment. Patients achieved an elevated serum KL-6 level of more than 450 U/ml with statistical significance when: 1) combination therapy was given (P=0.011), 2) serum KL-6 level pretreatment was high more than 300 U/ml (P=0.014).
The present study suggests that onset of interstitial pneumonia should be carefully checked in the combination therapy of pegylated-IFN and ribavirin.
本研究旨在评估聚乙二醇化干扰素（IFN）与利巴韦林联合治疗慢性丙型肝炎（CH）C患者是否会提高KL-6的血清水平，KL-6是间质性肺炎的敏感标志物。
按时间顺序回顾性选取经组织学证实并接受聚乙二醇化干扰素α-2b与利巴韦林联合治疗、IFN单药治疗或未治疗48周的CH C患者，每组25例。使用储存在-80℃的血清，在治疗开始前以及治疗或随访的12、24、36、48周时，通过酶联免疫吸附测定法测量血清KL-6水平。
接受聚乙二醇化干扰素与利巴韦林联合治疗的患者，血清KL-6平均水平在开始治疗后12周升高21%，24周升高23%以及48周升高28%。在接受聚乙二醇化干扰素与利巴韦林联合治疗的患者中，血清KL-6水平在治疗期间显著升高。当出现以下情况时，患者血清KL-6水平升高至超过450 U/ml具有统计学意义：1）给予联合治疗（P=0.011），2）血清KL-6水平预处理时高于300 U/ml（P=0.014）。
本研究表明，在聚乙二醇化干扰素与利巴韦林联合治疗中应仔细检查间质性肺炎的发生情况。
