Giusti G, Piccinino F, Ruggiero G, Galanti B, Lucchelli P E, Manzillo G, Sagnelli E, Utili R
Acta Hepatogastroenterol (Stuttg). 1977 Jun;24(3):131-9.
A total of 54 patients hospitalized for chronic active hepatitis were randomly treated, 29 with prednisolone (maintenance dose 15 mg/day) and 25 with depot synthetic corticotrophin (maintenance dose 1 mg/week, i.m.) and were followed up for 6 to 24 months or longer. In this series, young males predominated, the incidence of serum HBsAg positivity approached 80% in both treatment and no patient had initial evidence of cirrhosis or had autoimmune associated diseases. With either drug SGOT levels showed a decrease during the initial 12 months of therapy (p less than 0.05); initial jaundice, when present, had disappeared by the 3rd month of treatment. With both treatments globulins and gamma-globulins decreased significantly after 12 to 24 months of therapy. Serum HBsAg persisted in all but two cases. Serum liver biopsies showed the following evolutions of histological activity: 12 cases (22%) improved to the "inactive phase" (8 with prednisolone and 4 with corticotrophin); 19 (35%) improved to a lesser extent (8 with prednisolone and 11 with corticotrophin); 17 (32%) remained unchanged (11 with prednisolone and 6 with corticotrophin); 6 (11%) worsened (2 with prednisolone and 4 with corticotrophin). Morphological features of cirrhosis appearently developed in 15 patients (8 treated with prednisolone and 7 with corticotrophin) of whom 7 achieved improvement of histological aggressiveness concurrently. Differences between treatments were not significant. Side effects suggesting drug discontinuation occurred only in 6 cases.
共有54例因慢性活动性肝炎住院的患者接受随机治疗，其中29例使用泼尼松龙（维持剂量15毫克/天），25例使用长效合成促肾上腺皮质激素（维持剂量1毫克/周，肌肉注射），并随访6至24个月或更长时间。在该系列研究中，以年轻男性为主，治疗组血清HBsAg阳性率均接近80%，且无患者最初有肝硬化证据或患有自身免疫相关疾病。使用这两种药物中的任何一种，在治疗的最初12个月内血清谷草转氨酶水平均有所下降（p<0.05）；最初出现黄疸的患者在治疗第3个月时黄疸消失。两种治疗方法在治疗12至24个月后球蛋白和γ球蛋白均显著下降。除2例外，所有患者血清HBsAg均持续存在。血清肝活检显示组织学活性有以下演变：12例（22%）改善至“非活动期”（8例使用泼尼松龙，4例使用促肾上腺皮质激素）；19例（35%）有较小程度改善（8例使用泼尼松龙，11例使用促肾上腺皮质激素）；17例（32%）无变化（11例使用泼尼松龙，6例使用促肾上腺皮质激素）；6例（11%）恶化（2例使用泼尼松龙，4例使用促肾上腺皮质激素）。15例患者（8例使用泼尼松龙，7例使用促肾上腺皮质激素）出现了肝硬化的形态学特征，其中7例同时组织学侵袭性得到改善。治疗组之间的差异不显著。仅6例出现提示停药的副作用。
