Omata M, Ito Y, Yokosuka O, Imazeki F, Uchiumi K, Takano S, Hosoda K, Ohto M
First Department of Medicine, Chiba University School of Medicine, Japan.
Dig Dis Sci. 1989 Mar;34(3):330-7. doi: 10.1007/BF01536251.
We have treated 17 patients with non-A, non-B chronic hepatitis by recombinant interferon alpha (0.3-9 megaunits for 4-28 weeks). In six patients, serum aminotransferase levels fell to normal or near-normal range during treatment. The mean levels of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in 17 patients fell from 156 +/- 80 (mean +/- SD) and 213 +/- 135 at the beginning of treatment to 94 +/- 49 and 112 +/- 71, respectively, at the end of treatment. In 12 patients, liver biopsies were performed before and after (or during) the treatment, and histological activity indices (HAI) were blindly examined by two independent observers. For comparison, we examined histological changes of pre- and posttreatment liver biopsies of 19 patients who were treated by recombinant interferon for chronic hepatitis B. Mean HAI scores improved from 10.0 to 5.4 after treatment in non-A, non-B chronic hepatitis. The most marked reduction was noted in scores of portal inflammation and hepatocellular degeneration and/or necrosis. No such reduction was observed in B-viral chronic hepatitis. These data indicated that rapid biochemical resolution by the treatment was related to histological improvement of the liver in our patients with non-A, non-B hepatitis.
我们用重组干扰素α(0.3 - 9百万单位,疗程4 - 28周)治疗了17例非甲非乙型慢性肝炎患者。6例患者在治疗期间血清转氨酶水平降至正常或接近正常范围。17例患者血清天冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)的平均水平在治疗开始时分别为156±80(均值±标准差)和213±135,治疗结束时分别降至94±49和112±71。12例患者在治疗前及治疗后(或治疗期间)进行了肝活检,两位独立观察者对组织学活动指数(HAI)进行了盲法检查。为作比较,我们检查了19例接受重组干扰素治疗的慢性乙型肝炎患者治疗前后肝活检的组织学变化。非甲非乙型慢性肝炎患者治疗后HAI平均评分从10.0降至5.4。门脉炎症及肝细胞变性和/或坏死评分下降最为明显。在乙型病毒性慢性肝炎中未观察到这种下降。这些数据表明,在我们的非甲非乙型肝炎患者中,治疗导致的快速生化指标改善与肝脏组织学改善相关。