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目的:观察聚乙二醇干扰素α-2a(PEG-INFα-2a)治疗慢性乙型肝炎(CHB)前后患者的肝组织病理变化。方法:对符合条件的12例CHB患者使用PEG-INFα-2a 180μg,sc,1次/周,连用48周,分别于治疗前及停药后第24周行肝穿,对治疗前后的肝活检组织分别进行炎症和纤维化分级计分,统计学分析。结果:治疗后肝组织炎症和坏死记分较治疗前降低,点状融合坏死治疗前后统计学差异显著(P<0.05)。组织病变活动性(HAI)积分、汇管区周围坏死、和汇管区炎症积分,均较治疗前有明显下降,但差异无显著性,而治疗后的纤维化积分则未见明显下降。结论:PEG-INFα-2a能有效改善慢性乙型肝炎病人的肝组织学状况,但对已经发生纤维化的肝组织未见明显改善。
Objective: To observe the pathological changes of liver in patients with chronic hepatitis B (CHB) treated with pegylated interferon α-2a (PEG-INFα-2a). Methods: 12 eligible CHB patients were treated with PEG-INFα-2a 180 μg, sc, once a week for 48 weeks before and after treatment. The liver biopsy was performed before and after treatment Tissue were graded and scored for inflammation and fibrosis respectively and statistically analyzed. Results: The score of inflammation and necrosis of liver tissue after treatment was lower than that before treatment, and the difference was statistically significant (P <0.05) before and after treatment. HAI score, necrosis around portal area and inflammation score in portal area were significantly lower than those before treatment, but the difference was insignificant, but there was no significant decrease in fibrosis score after treatment. Conclusion: PEG-INFα-2a can effectively improve the liver histology in patients with chronic hepatitis B, but there is no significant improvement in the liver tissue that has been fibrotic.