Hoofnagle J H, Davis G L, Pappas S C, Hanson R G, Peters M, Avigan M I, Waggoner J G, Jones E A, Seeff L B
Ann Intern Med. 1986 Jan;104(1):12-7. doi: 10.7326/0003-4819-104-1-12.
Fifteen patients with chronic type B hepatitis were treated with corticosteroids in a randomized, double-blind, placebo-controlled trial lasting 28 days. Ten patients received prednisolone, 60 mg/d for 2 weeks, then 30 mg/d for another 2 weeks; 5 patients received placebo. Serum aminotransferase levels decreased significantly during prednisolone therapy but 4 to 10 weeks after abrupt withdrawal of the drug, they rebounded to levels greater than those before treatment. This exacerbation of disease lasted for several months and was prolonged and symptomatic in 3 patients. Hepatitis B virus levels did not change substantially during treatment. Follow-up examinations showed no improvement in biochemical or serologic features of the disease in any of the 15 patients; follow-up liver biopsies showed a worsening in 4 of 7 treated patients but in 0 of 5 control patients. Thus, a 28-day course of prednisolone produced no beneficial effects in patients with mild-to-moderate chronic type B hepatitis; on the contrary, such treatment may be harmful.
在一项为期28天的随机、双盲、安慰剂对照试验中，对15例慢性乙型肝炎患者使用了皮质类固醇。10例患者接受泼尼松龙治疗，每天60毫克，持续2周，然后每天30毫克，再持续2周；5例患者接受安慰剂治疗。在泼尼松龙治疗期间，血清转氨酶水平显著下降，但在突然停药后的4至10周，它们反弹至高于治疗前的水平。这种疾病的恶化持续了几个月，3例患者的病情持续时间延长且有症状。治疗期间乙肝病毒水平没有实质性变化。随访检查显示，15例患者中没有任何一例的疾病生化或血清学特征得到改善；随访肝脏活检显示，7例接受治疗的患者中有4例病情恶化，而5例对照患者中无一例恶化。因此，为期28天的泼尼松龙疗程对轻至中度慢性乙型肝炎患者没有产生有益效果；相反，这种治疗可能有害。
