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对14例慢性活动性乙肝表面抗原阳性、乙肝e抗原阳性的肝炎患者口服低剂量天然人α干扰素进行治疗。

Treatment of fourteen chronic active HBsAg+, HBeAg+ hepatitis patients with low dose natural human interferon alpha administered orally.

作者信息

Zielińska W, Paszkiewicz J, Korczak A, Własiuk M, Zółtowska A, Szutowicz A, Cummins J M, Georgiades J A

机构信息

Clinic for Infectious Diseases, Medical Academy, Gdańsk, Poland.

出版信息

Arch Immunol Ther Exp (Warsz). 1993;41(3-4):241-51.

PMID:8129568
Abstract

The therapy concept is based on a theory of the immunocorrective effect of orally administered natural human interferon alpha in low doses (leuHuIFN alpha (ldou)), manifolded by the logistic amplification system seated in the oral cavity. Fourteen randomly selected patients with chronic active type B hepatitis, aged 7-59 years, were assigned to treatment. All the patients had been treated for several months to several years with steroids, with no beneficial effect--clinical and biochemical symptoms of active liver disease, with histopathological progression (up to liver cirrhosis) had been permanently present. Treatment with leuHuIFN alpha (ldou) (doses: 50-100 U daily) was introduced immediately after the immunosuppression (steroids, steroids+azathioprine) discontinuation, and its influence on the course of the disease was monitored by means of hematological and biochemical tests, humoral and cellular immune response parameters, serological markers of HBV infection, HBV DNA concentration and immunohistochemical evaluation of liver biopsy specimens. The observation period ranges from 15 to 32 months. In all patients, within the first 3-6 weeks of treatment, transient deterioration of biochemical liver function tests was noted (e.g. 2-3 fold increase of ALAT), with no clinical symptoms of the disease exacerbation. The phenomenon lasted for 4-16 weeks. In all the treated patients, intensive immune system activation was seen, which lasted beyond the therapy period. Seven patients eliminated serum HBV DNA; all of them also eliminated HBeAg and seroconverted to HBeAb. Up to date, one person have lost serum HBsAg, in nine others its titre decreased significantly.

摘要

该治疗理念基于低剂量口服天然人α干扰素(亮氨酸化人α干扰素(低剂量))的免疫纠正作用理论,其通过口腔中的逻辑放大系统得以体现。随机选取了14名年龄在7至59岁之间的慢性活动性乙型肝炎患者进行治疗。所有患者此前已接受数月至数年的类固醇治疗,但均无有益效果——活动性肝病的临床和生化症状以及组织病理学进展(直至肝硬化)一直存在。在停用免疫抑制剂(类固醇、类固醇+硫唑嘌呤)后,立即开始使用亮氨酸化人α干扰素(低剂量)(剂量:每日50 - 100单位)进行治疗,并通过血液学和生化检测、体液和细胞免疫反应参数、HBV感染的血清学标志物、HBV DNA浓度以及肝活检标本的免疫组化评估来监测其对疾病进程的影响。观察期为15至32个月。在所有患者中,治疗的前3至6周内,均出现了生化肝功能检测结果的短暂恶化(例如,谷丙转氨酶升高2至3倍),但无疾病加重的临床症状。这种现象持续了4至16周。在所有接受治疗的患者中,均观察到免疫系统的强烈激活,且这种激活在治疗期后仍持续存在。7名患者清除了血清HBV DNA;他们全部还清除了HBeAg并血清转化为HBeAb。截至目前,有1人血清HBsAg消失,另外9人的HBsAg滴度显著下降。

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