Peg-干扰素抗病毒治疗ALT正常的慢性HBV感染的疗效

Efficacy of Peg-interferon antiviral therapy for chronic HBV infection with normal ALT

    摘要
  • 摘要:
    目的 分析聚乙二醇(Peg)-干扰素抗病毒治疗丙氨酸转氨酶(ALT)正常的慢性乙型肝炎病毒(HBV)感染的疗效及对外周血T细胞免疫状态的影响，为临床ALT正常的慢性HBV感染治疗提供参考。
    方法 回顾性分析2020年1月-2023年12月沧州市中心医院及沧州市传染病医院诊治的95例ALT正常的慢性HBV感染患者的病历资料，根据患者治疗方式分为Peg-干扰素治疗组(59例)与常规治疗组(36例)；收集并比较两组患者一般资料和临床疗效，检测并记录两组患者治疗前、治疗48周后血清ALT、谷草转氨酶(AST)、乙型肝炎表面抗原(HBsAg)、乙肝e抗原(HBeAg)、HBV DNA定量变化情况，通过流式细胞术分析患者治疗前、治疗48周后CD4+ T、CD8+ T细胞的表达水平。
    结果 两组HBsAg清除率、HBeAg转阴率、HBV DNA转阴率比较，差异均有统计学意义(P＜0.05)，Peg-干扰素治疗组HBsAg清除率(22.03%)高于常规治疗组(2.78%)，Peg-干扰素治疗组HBeAg转阴率(93.22%)高于常规治疗组(52.78%)，Peg-干扰素治疗组HBV DNA转阴率(100.00%)高于常规治疗组(77.78%)；治疗48周后，两组患者血清HBsAg、HBeAg、HBV DNA水平均有所降低，且与常规治疗组比较，Peg-干扰素治疗组血清HBsAg、HBeAg、HBV DNA降低幅度更大(P < 0.05)，治疗48周后，两组患者CD4+水平有所降低，CD8+水平升高，且与常规治疗组比较，Peg-干扰素治疗组CD4+水平降低幅度、CD8+水平升高幅度更大(P < 0.05)；治疗48周后，两组患者血清ALT、AST水平均有所升高(P < 0.05)。
    结论 Peg-干扰素抗病毒治疗ALT正常的慢性HBV感染患者疗效显著，可减轻肝脏损伤程度，提高患者免疫力与抗病毒疗效。

     

    Abstract:
    OBJECTIVE To analyze the efficacy of polyethylene glycol (Peg)-interferon antiviral therapy for chronic hepatitis B virus (HBV) infection with normal alanine transaminase (ALT) and the effect on the status of peripheral blood T cells, to provide references for the treatment of chronic HBV infection with normal ALT.
    METHODS The medical records of 95 patients with chronic HBV infection and normal ALT admitted to the infection department of Cangzhou Central Hospital and Cangzhou Infectious Disease Hospital from Jan. 2020 to Dec. 2023 were retrospectively analyzed, and were divided into the Peg-interferon treated group (59 cases) and the conventionally treated group (36 cases). The general data and clinical efficacy in the two groups were collected and compared, and the serum ALT, aspartate aminotransferase (AST), hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and HBV DNA were detected and recorded in the two groups before and after 48 weeks of treatment, CD4+ and CD8+ T cells were also analyzed by flow cytometry.
    RESULTS HBsAg clearance rate, negative conversion rate of HBeAg and HBV DNA in PEG-interferon treated group was higher than that in conventionally treated group (22.03% vs. 2.78%, 93.22% vs. 52.78%, 100.00% vs. 77.78%, respectively, P < 0.05). At 48 weeks of treatments, serum HBsAg, HBeAg, HBV DNA levels decreased in both groups, and decreased markedly in the Peg-Interferon treated group when compared with the conventionally treated group (P < 0.05); meanwhile, the level of CD4+ decreased and CD8+ elevated in both groups, the changes in CD4+ and CD8+ levels were significant in the Peg-interferon treated group when compared with the conventionally treated group (P < 0.05). The levels of serum ALT and AST of the two groups of patients were elevated after the treatment for 48 weeks (P < 0.05).
    CONCLUSION The efficacy of Peg-interferon antiviral treatment for chronic HBV-infected patients with normal ALT is remarkable, which can reduce the severity of liver damage and improve the immunity and antiviral efficacy of patients.

     

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