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α-干扰素治疗慢性丙型肝炎:一项对照、多中心、前瞻性研究。

alpha-Interferon treatment of chronic hepatitis C: a controlled, multicentre, prospective study.

作者信息

Angelini G, Sgarbi D, Colombari R, Bezzi A, Castagnini A, de Berardinis F, Conti A, di Piramo D, Dolci L, Falezza G

机构信息

Istituto di Clinica Medica, Università di Verona, Italia.

出版信息

Digestion. 1995;56(3):199-203. doi: 10.1159/000201243.

Abstract

This prospective, controlled study was designed in order to evaluate the response rate to alpha-interferon (IFN) versus no treatment in 63 patients affected by chronic hepatitis C. Fifty-two patients were randomly chosen to receive no treatment of IFN alfa-2b (6 MU 3 times weekly for the first month and 3 MU for the next 11 months). Eleven additional patients were crossed to active treatment after a 1-year control period without any change of serum pattern and were therefore enrolled both as controls and cases. Four patients had to be withdrawn from the active treatment for adverse effects. Sixteen out of the remaining 23 had normal alanine aminotransferase (ALT) values at the end of the treatment, and 14 were still normal 12 months later. A liver biopsy, taken 6 months after the end of the treatment, showed improvement in 12 patients and normalization in 1. Only 1 out of the 25 controls had transaminase normalization and 5 a decrease. One of them showed also a histological improvement. Eight of the 11 case/control patients showed ALT normalization after IFN administration, 5 of them histological improvement and 2 liver normalization. Hepatitis C virus (HCV) RNA became negative in 13 of 17 cases in whom the assay was carried out. Therefore this study confirms that the longterm administration of alpha-IFN induced a prolonged remission of disease activity in over 50% of the patients and the clearance of HCV RNA in the majority of the responders.

摘要

这项前瞻性对照研究旨在评估63例慢性丙型肝炎患者接受α干扰素(IFN)治疗与不治疗的反应率。52例患者被随机选择不接受IFNα-2b治疗(第一个月每周3次,每次6 MU,接下来11个月每周3 MU)。另外11例患者在1年的对照期后,血清模式无任何变化,转而接受积极治疗,因此既作为对照组又作为病例组纳入研究。4例患者因不良反应不得不退出积极治疗。在剩余的23例患者中,16例在治疗结束时丙氨酸转氨酶(ALT)值正常,14例在12个月后仍正常。治疗结束6个月后进行的肝活检显示,12例患者病情改善,1例正常。25例对照组患者中只有1例转氨酶正常,5例下降。其中1例也有组织学改善。11例病例/对照患者中有8例在给予IFN后ALT正常,5例有组织学改善,2例肝脏正常。在进行检测的17例病例中,13例丙型肝炎病毒(HCV)RNA转为阴性。因此,本研究证实,长期给予α干扰素可使超过50%的患者疾病活动长期缓解,并使大多数反应者的HCV RNA清除。

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