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丙型肝炎患者对干扰素反应的预测因素。

Factors predictive of the response to interferon in patients with chronic hepatitis C.

作者信息

Serfaty L, Giral P, Loria A, Andréani T, Legendre C, Poupon R

机构信息

Unité d'Hépatogastroentérologie, Hôpital Saint-Antoine, Paris, France.

出版信息

J Hepatol. 1994 Jul;21(1):12-7. doi: 10.1016/s0168-8278(94)80130-4.

Abstract

Factors predictive of the response to interferon in patients with chronic hepatitis C remain to be identified. In this study, we investigated factors predictive of the short-term response, defined as a return to normal alanine aminotransferase activity after treatment, and the long-term response defined as normal alanine aminotransferase activity 1 year after completing treatment, in 75 patients with chronic hepatitis C virus treated with recombinant alpha interferon (either 6 MU x 3/week for 3 months then 3 MU x 3/week for 3 months (n = 27) or 3 MU x 3/week for 6 months (n = 48)). At the end of treatment, 42 patients (56%) had normal alanine aminotransferase activity ("responders") and 33 (44%) had high alanine aminotransferase activity ("non-responders"). Twenty (48%) of the 42 responders had normal alanine aminotransferase activity 1 year after treatment ("sustained responders"), while 22 (52%) had high alanine aminotransferase activity ("transient responders"). The dosage of interferon was not predictive of the short-term and the long-term response to treatment. The responders differed significantly from the non-responders in terms of age, i.v. drug abuse, aspartate aminotransferase, gammaglutamyltranspeptidase and alkaline phosphatase activities, bilirubinemia, serum bile acid concentrations, prothrombin time, platelet count, ferritinemia, hyaluronic acid levels, positivity for the antibody to 5.1.1 of the recombinant immunoblot assay band and the histological fibrosis score. The following parameters were independently correlated with the short-term response in a multivariate analysis: gammaglutamyltranspeptidase activity, serum bile acid concentrations and positivity for the antibody to 5.1.1 of the recombinant immunoblot assay band.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

慢性丙型肝炎患者中预测干扰素治疗反应的因素仍有待确定。在本研究中,我们调查了75例接受重组α干扰素治疗的慢性丙型肝炎病毒患者的短期反应(定义为治疗后丙氨酸转氨酶活性恢复正常)和长期反应(定义为完成治疗1年后丙氨酸转氨酶活性正常)的预测因素。治疗方案为:27例患者接受6 MU×3/周治疗3个月,然后3 MU×3/周治疗3个月;48例患者接受3 MU×3/周治疗6个月。治疗结束时,42例患者(56%)丙氨酸转氨酶活性正常(“反应者”),33例患者(44%)丙氨酸转氨酶活性高(“无反应者”)。42例反应者中有20例(48%)在治疗1年后丙氨酸转氨酶活性正常(“持续反应者”),22例(52%)丙氨酸转氨酶活性高(“短暂反应者”)。干扰素剂量不能预测治疗的短期和长期反应。反应者与无反应者在年龄、静脉药物滥用、天冬氨酸转氨酶、γ-谷氨酰转肽酶和碱性磷酸酶活性、胆红素血症、血清胆汁酸浓度、凝血酶原时间、血小板计数、铁蛋白血症、透明质酸水平、重组免疫印迹分析条带5.1.1抗体阳性及组织学纤维化评分方面存在显著差异。多因素分析显示,以下参数与短期反应独立相关:γ-谷氨酰转肽酶活性、血清胆汁酸浓度及重组免疫印迹分析条带5.1.1抗体阳性。(摘要截短于250字)

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