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[重组α2b干扰素治疗儿童和青少年B病毒所致慢性活动性肝炎的长期研究]

[Long term study of the treatment with recombinant alfa 2b interferon in chronic active hepatitis due to B virus in children and adolescents].

作者信息

Castañeda Guillot C, Escobar Capote M D, García Bacallao E, Borbolla Bousquets E

机构信息

Instituto Nacional de Gastroenterología, Sección de Gastroenterología Pediátrica La Habana, Cuba.

出版信息

G E N. 1994 Oct-Dec;48(4):219-25.

PMID:7557276
Abstract

To assess the efficacy of recombinant alfa 2b-interferon treatment "Heberon alfa R" in children with chronic active hepatitis (CAH) B virus, we conducted a long-term study (three years) in 22 children infected with hepatitis B virus (17 males and 5 females), age range 3 to 15 years. Diagnostic criteria included the clinical picture, laboratory tests, virus markers (HBeAg, HBsAg), laparoscopy and liver biopsy. Children under 12 years received 3 million IU of interferon per day whereas those older than 12 years received 6 million IU of interferon per day by intramuscular injection, three times per week for four months. Alanine aminotransferase (ALT) levels had been elevated for six months in all patients and hepatitis B viral infection was replicative. A variance analysis was made to evaluate ALT response to interferon administration and the Mc Nemar test was used to analyze HBeAg/anti-HBe behavior. Seventeen (77%) out of 22 patients responded to treatment (clearance of HBeAg and ALT levels returned to normal. HBeAg seroconversion (anti-HBe) occurred in 36% of patients during the first year (p < 0.01) and it increased to 50% by the third year follow-up. ALAT levels also decreased and the difference was statistically significant (p < 0.01). This occurred during and after treatment with a steady and increasing tendency to return to normal levels within the first and third year. Side effects were scarce, transient and tolerable and they only appeared during the initial phase of treatment; symptoms were mainly influenza-like and they disappeared very soon. There were no late side effects such as medullar depression, renal toxicity and glycemia alterations.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为评估重组α2b干扰素“赫伯龙αR”治疗儿童慢性乙型活动性肝炎(CAH)的疗效,我们对22例感染乙型肝炎病毒的儿童(17例男性和5例女性,年龄范围3至15岁)进行了一项为期三年的长期研究。诊断标准包括临床表现、实验室检查、病毒标志物(HBeAg、HBsAg)、腹腔镜检查和肝活检。12岁以下儿童每天接受300万国际单位干扰素,12岁以上儿童每天接受600万国际单位干扰素,通过肌肉注射,每周三次,共四个月。所有患者的丙氨酸转氨酶(ALT)水平已升高六个月,且乙型肝炎病毒感染处于复制状态。进行方差分析以评估ALT对干扰素给药的反应,并使用Mc Nemar检验分析HBeAg/抗HBe行为。22例患者中有17例(77%)对治疗有反应(HBeAg清除且ALT水平恢复正常)。36%的患者在第一年出现HBeAg血清转换(抗HBe)(p<0.01),到第三年随访时增加到50%。ALAT水平也下降,差异具有统计学意义(p<0.01)。这在治疗期间和治疗后发生,且有稳定且不断增加的趋势在第一年和第三年内恢复到正常水平。副作用很少、短暂且可耐受,仅在治疗初期出现;症状主要为流感样,很快消失。没有诸如骨髓抑制、肾毒性和血糖改变等晚期副作用。(摘要截短为250字)

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