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重组人α干扰素治疗慢性非甲非乙型肝炎患者:一项来自法国的多中心随机对照试验

Recombinant human alpha-interferon in patients with chronic non-A, non-B hepatitis: a multicenter randomized controlled trial from France.

作者信息

Marcellin P, Boyer N, Giostra E, Degott C, Courouce A M, Degos F, Coppere H, Cales P, Couzigou P, Benhamou J P

机构信息

Service d'Hépatologie, Unité de Recherches de Physiopathologie Hépatique (INSERM U24), France.

出版信息

Hepatology. 1991 Mar;13(3):393-7.

PMID:1900254
Abstract

We have conducted a multicenter randomized controlled trial comparing two doses of recombinant human alpha-interferon for efficacy in 60 patients with chronic non-A, non-B hepatitis. The source of infection appeared to be transfusion in 30 patients, intravenous drug abuse in 16 patients and was unknown in 14 patients. Patients were randomly assigned to no treatment or to treatment with either 1 or 3 MU of alpha-interferon given three times a week for 24 wk. Forty-five patients (75%) were positive for antibody to hepatitis C virus. During the 24-wk treatment period, mean serum ALT levels decreased in both treatment groups, but the decrease was statistically significant only in the 3 MU group. However, at 24 wk, the proportion of patients with normal ALT levels was similar in the 3 MU group (39%) and the 1 MU group (45%), and both were significantly higher than in controls (0%). Repeat liver biopsy specimens showed a significant decrease in the severity of histological changes in the 3 MU group but not in the 1 MU group or in controls. Responses to alpha-interferon did not correlate with patient's age, gender, source of infection, pretreatment serum ALT, presence of anti-hepatitis C virus or cirrhosis. After treatment, the mean ALT levels rose in both treated groups. The proportion of patients with normal ALT levels at wk 48 was 28% in the 3 MU group and 20% in the 1 MU group. In conclusion, a dose of 3 MU was superior to 1 MU of alpha-interferon given three times weekly for 24 wk in inducing improvements in serum ALT levels and liver histological examinations.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们进行了一项多中心随机对照试验,比较两种剂量的重组人α干扰素对60例慢性非甲非乙型肝炎患者的疗效。30例患者的感染源似乎是输血,16例是静脉注射毒品,14例感染源不明。患者被随机分配至不治疗组,或接受每周3次、每次1或3百万单位α干扰素治疗,共24周。45例患者(75%)丙肝病毒抗体呈阳性。在24周的治疗期内,两个治疗组的血清谷丙转氨酶(ALT)平均水平均下降,但仅3百万单位组的下降具有统计学意义。然而,在24周时,3百万单位组(39%)和1百万单位组(45%)谷丙转氨酶水平正常的患者比例相似,且均显著高于对照组(0%)。重复肝活检标本显示,3百万单位组组织学改变的严重程度显著降低,而1百万单位组和对照组未降低。α干扰素的反应与患者的年龄、性别、感染源、治疗前血清ALT、丙肝病毒抗体或肝硬化的存在无关。治疗后,两个治疗组的平均ALT水平均升高。在48周时,3百万单位组谷丙转氨酶水平正常的患者比例为28%,1百万单位组为20%。总之,每周3次、每次3百万单位α干扰素治疗24周,在改善血清ALT水平和肝脏组织学检查方面优于每周3次、每次1百万单位α干扰素。(摘要截选至250词)

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