病毒性肝炎患者α干扰素中和抗体的发生率及其意义

• 作 者: 童福易 唐永煌 张立伐
• 机 构: 暨南大学医学院第一附属医院感染病科
• 出 处: 中国病理生理杂志
• 发表日期: 1998年06期
• 关键词: α干扰素 中和抗体 肝炎患者血清 干扰素类 阴转率 抗病毒药物 月检 全部阳性 复发率 生物测定法

目的：探讨α干扰素（ＩＦＮα）中和抗体产生的规律及其意义。方法：采用抗病毒中和生物测定法检测３２例健康人和１１６例ＩＦＮα治疗的慢性肝炎患者血清中的ＩＦＮα的中和抗体（ＮＡ）。结果：健康人及ＩＦＮα治疗前的患者均未检出ＮＡ。治疗后共２０例（１７２％）阳性，其中４例是在治疗后第２个月检出，２０例第６个月全部阳性，ＩＦＮ－α２ａ、ＩＦＮ－α２ｂ、ＩＦＮ－α１ｂ治疗组的ＮＡ阳性率分别为３４６％、１３２％、１１５％。ＮＡ阳性组、ＮＡ高滴度组的病毒清除率显著低于ＮＡ阴性组、ＮＡ低滴度组（Ｐ＜００１），相反病毒复发率在ＮＡ阳性组显著高于ＮＡ阴性组（Ｐ＜００５）。治疗前ＡＬＴ高水平组的ＮＡ阳性率显著低于ＡＬＴ低水平组（Ｐ＜００５），而前者的病毒阴转率显著高于后者（Ｐ＜００５）。结论：提示ＩＦＮα治疗后ＮＡ发生率较低，其产生有一定的时间规律。ＮＡ可影响治疗效果，对治疗前ＡＬＴ水平的了解有助于病例的选择

Objective: To investigate the regularity and significance of the production of neutralizing antibodies (IFNα). Methods: Neutralizing antibodies (NA) in serum of 32 healthy individuals and 116 patients with chronic hepatitis treated with IFNα were detected by antiviral neutralization bioassay. Results: No NA was detected in healthy individuals and patients before IFNα treatment. After treatment, a total of 20 cases (172%) were positive, of which 4 cases were detected at the second month after treatment, 20 cases were all 6 months positive, IFN-α2a, IFN-α2b, IFN-α1b treatment group The positive rates of NA were 346%, 132% and 115% respectively. NA positive group and NA high titer group were significantly lower than those in NA negative group and NA low titer group (P <001). In contrast, the virus recurrence rate in NA positive group was significantly higher than that in NA negative group (P < 0  05). The positive rate of NA in high ALT group before treatment was significantly lower than that in ALT low group (P <005), while the former was significantly higher than the latter (P <005). Conclusion: It suggests that the incidence of NAA after IFNα treatment is low, and its production has a certain time pattern. NA can affect the treatment effect, understanding the level of pre-treatment ALT contributes to the choice of case