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用淋巴母细胞干扰素治疗慢性散发性非甲非乙型肝炎:γ-谷氨酰转移酶水平对疗效的预测作用

Treatment of chronic sporadic-type non-A, non-B hepatitis with lymphoblastoid interferon: gamma GT levels predictive for response.

作者信息

Mazzella G, Salzetta A, Casanova S, Morelli M C, Villanova N, Miniero R, Sottili S, Novelli V, Cipolla A, Festi D

机构信息

Cattedra di Gastroenterologia, University of Bologna, Italy.

出版信息

Dig Dis Sci. 1994 Apr;39(4):866-70. doi: 10.1007/BF02087435.

Abstract

The aim of this study was to evaluate the efficacy of human lymphoblastoid interferon-alpha treatment in chronic sporadic-type non-A, non-B hepatitis. We also aimed to determine if histological or liver function data could predict either response or relapse. Sixty patients with chronic sporadic-type non-A, non-B hepatitis were randomized in two groups of 30. One group was treated with interferon-alpha (3 MU thrice weekly) for one year; the other group was untreated controls. The treated group was followed for another year after interferon withdrawal. Liver function tests were performed during treatment. Liver biopsy was carried out before and a year after randomization. We evaluated rate of response [normalization of alanine aminotransferase (ALT) levels for at least three consecutive months] and rate of relapse (ALT rebound after therapy suspension). We also looked at possible predictive factors for response and relapse. In the treatment group the rate of response was 55% (16/29). No control patient exhibited ALT normalization. Among the responders, 31% (5/16) relapsed after interferon withdrawal. Low gamma GT and female sex are positive predictive factors of response (P < 0.01 and P < 0.02 respectively). Presence of portal and periportal inflammation at the second liver biopsy was correlated with relapse (P < 0.05). In conclusion, human lymphoblastoid interferon-alpha treatment for one year is beneficial in patients suffering from chronic sporadic-type non-A, non-B hepatitis. Low pretreatment gamma GT levels and female sex are positive predictors of response in this patient population.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究的目的是评估人淋巴母细胞干扰素-α治疗慢性散发性非甲非乙型肝炎的疗效。我们还旨在确定组织学或肝功能数据是否能够预测疗效或复发情况。60例慢性散发性非甲非乙型肝炎患者被随机分为两组,每组30例。一组接受干扰素-α治疗(3 MU,每周3次),持续1年;另一组为未治疗的对照组。治疗组在停用干扰素后再随访1年。治疗期间进行肝功能检查。随机分组前及1年后进行肝活检。我们评估了应答率(丙氨酸转氨酶(ALT)水平连续至少3个月恢复正常)和复发率(治疗中止后ALT反弹)。我们还研究了应答和复发的可能预测因素。治疗组的应答率为55%(16/29)。对照组患者无ALT恢复正常者。在应答者中,31%(5/16)在停用干扰素后复发。低γ-GT和女性是应答的阳性预测因素(分别为P<0.01和P<0.02)。第二次肝活检时门静脉和门周炎症的存在与复发相关(P<0.05)。总之,人淋巴母细胞干扰素-α治疗1年对慢性散发性非甲非乙型肝炎患者有益。治疗前低γ-GT水平和女性是该患者群体应答的阳性预测指标。(摘要截选至250词)

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