Giusti G, Ruggiero G, Galanti B, Piccinino F, Russo M, Galante D, Sagnelli E, Utili R, Pasquale G, Nardiello S, Aloisio V
Hepatogastroenterology. 1981 Oct;28(5):245-9.
The authors review the course of disease in 130 patients (87 HBsAg-positive and 43 HBsAg-negative) with chronic active hepatitis (CAH) observed in the last six years. Patients were treated with prednisone (36 HBsAg-positive an 8 HBsAg-negative), azathioprine (7 HBsAg-positive and 12 HBsAg-negative) or a combination of prednisone and azathioprine (23 HBsAg-positive and 14 HBsAg-negative), or remained untreated (21 HBsAg-positive and 9 HBsAg-negative). Among HBsAg-positive patients improvement was observed in 54% of the 66 patients treated, and in none of the 21 untreated patients (P less than 0.001). Treatment did not modify the course of the disease in HBsAg-negative patients with CAH; this is probably related either to the small number of patients in each treatment group, or to geographical differences. Furthermore treatment was not effective in patients older than 40 years, whether HBsAg-positive or HBsAg-negative. Three out of 87 HBsAg-positive patients, and two out of the 43 HBsAg-negative patients had died by the end of the observation period irrespective of treatment. Full remission with clearance of HBsAg was observed only in one patient after 4 years of treatment with steroids.
作者回顾了过去六年中观察到的130例慢性活动性肝炎（CAH）患者（87例HBsAg阳性和43例HBsAg阴性）的病程。患者接受泼尼松治疗（36例HBsAg阳性和8例HBsAg阴性）、硫唑嘌呤治疗（7例HBsAg阳性和12例HBsAg阴性）或泼尼松与硫唑嘌呤联合治疗（23例HBsAg阳性和14例HBsAg阴性），或未接受治疗（21例HBsAg阳性和9例HBsAg阴性）。在HBsAg阳性患者中，66例接受治疗的患者中有54%病情改善，而21例未接受治疗的患者中无一例病情改善（P小于0.001）。治疗并未改变HBsAg阴性的CAH患者的病程；这可能与每个治疗组的患者数量较少或地域差异有关。此外，治疗对40岁以上的患者无效，无论其HBsAg阳性或阴性。在观察期结束时，87例HBsAg阳性患者中有3例死亡，43例HBsAg阴性患者中有2例死亡，与治疗无关。仅1例患者在接受类固醇治疗4年后出现HBsAg清除并完全缓解。
