CAJ | 학술논문

目的：探讨聚乙二醇IFN α-2a联合利巴韦林对自身免疫抗体阳性慢性丙型肝炎的临床疗效。方法慢性丙型肝炎病毒(HCV)感染者102例，筛查自身抗体，分为自身抗体阳性组和阴性组，均给予IFN α-2a联合利巴韦林治疗。观察治疗前HCV RNA载量、治疗过程中血ALT和AST水平变化、病毒学应答情况及不良反应。结果102例慢性HCV感染者中，共检出自身抗体阳性患者31例，其中，抗线粒体抗体( AMA)阳性18例，抗平滑肌抗体( SMA)阳性10例，抗1型肝肾微粒抗体( LKM1)阳性3例。治疗前，阳性组和阴性组 HCV RNA载量，以及治疗后快速和持续病毒学应答率比较差异无统计学意义。治疗0~20周，两组患者ALT和AST水平比较差异无统计学意义(P>0．05)，治疗24周后，阳性组高于阴性组。两组患者的不良反应发生率比较差异无统计学意义。结论聚乙二醇IFN α-2a联合利巴韦林可有效治疗自身抗体阳性和阴性慢性丙型肝炎患者，自身抗体的存在与否对治疗安全性无明显影响。
목적：탐토취을이순IFN α-2a연합리파위림대자신면역항체양성만성병형간염적림상료효。방법만성병형간염병독(HCV)감염자102례，사사자신항체，분위자신항체양성조화음성조，균급여IFN α-2a연합리파위림치료。관찰치료전HCV RNA재량、치료과정중혈ALT화AST수평변화、병독학응답정황급불량반응。결과102례만성HCV감염자중，공검출자신항체양성환자31례，기중，항선립체항체( AMA)양성18례，항평활기항체( SMA)양성10례，항1형간신미립항체( LKM1)양성3례。치료전，양성조화음성조 HCV RNA재량，이급치료후쾌속화지속병독학응답솔비교차이무통계학의의。치료0~20주，량조환자ALT화AST수평비교차이무통계학의의(P>0．05)，치료24주후，양성조고우음성조。량조환자적불량반응발생솔비교차이무통계학의의。결론취을이순IFN α-2a연합리파위림가유효치료자신항체양성화음성만성병형간염환자，자신항체적존재여부대치료안전성무명현영향。
Objective To research the therapeutic effect of pegylated interferon α-2a (Peg-IFNα-2a) com-bined with ribavirin on chronic hepatitis C with positive autoantibodies. Methods The autoantibodies were screened in 102 cases of chronic hepatitis C patients,and the patients were divided into positive group and negative group. Both the two groups were given Peg-IFNα-2a combined with ribavirin. The HCV RNA,virological response rate,blood concen-trations of ALT and AST,and the adverse effects were observed before and after treatment. Results 31 cases were positive in the autoantibodies test,including 18 cases of AMA,10 cases of SAM and 3 cases of LKM1. There was no significant difference in the quantity of HCV RNA and the virological response rate between the two groups before and after treatment. The concentrations of ALT and AST in positive group were slightly higher than those of negative group before and at 0~20 weeks after treatment with no significant difference(P>0. 05),but there was significant difference after 24 weeks of treatment. No significant difference was found in the adverse effects rate between the two groups( P>0. 05). Conclusion Peg-IFNα-2a combined with ribavirin is effective for chronic hepatitis C patients with or without autoantibodies. The autoantibodies have no effect on the safety of the treatment.