聚乙二醇干扰素治疗慢性乙型肝炎患者血清干扰素浓度及其抗体水平的变化

摘要

目的 探讨聚乙二醇干扰素α2a治疗慢性乙型肝炎(CHB)患者血清干扰素浓度和干扰素抗体水平的变化,以及其对疗效的影响.方法 41例CHB患者皮下注射聚乙二醇干扰素α2a(派罗欣,罗氏公司)180μg,每周1次,在0、4、12、24和48周时用ELISA法检测干扰素浓度和干扰素抗体水平,并在停药后24周检测干扰素浓度.结果 干扰素浓度在0、4、12、24、48周和停药24周时分别为22.9(3.1～45.8) pg/mL、2 734(9.2～4 224)pg/mL、4 025(269～4 462)pg/mL、3 884(14.5～4 567)pg/mL、3 978(76.9～5 227)pg/mL和62.1 (52.3～74.6)pg/mL.干扰素浓度在4、12、24、48周和停药24周与0周相比,差异有统计学意义(t=9.481,P＜0.01;Z =-6.862,P＜0.01;Z=6.969,P＜0.01；Z=-6.477,P＜0.01;Z=-4.204,P＜0.01)；12、24与4周相比,差异有统计学意义(Z=-4.316,P＜0.01；Z=-3.830,P=0.000 1)；24周与12周相比,差异无统计学意义(Z=0.367,P=0.713 6).干扰素抗体水平在4、12、24、48与0周相比,差异无统计学意义(Z=-1.035,P=0.300 7;Z=0.101,P=0.919 2;Z=0.158,P=0.874 8;Z=1.779,P=0.075 2).结论 聚乙二醇干扰素α2a治疗过程中,患者血清干扰素浓度在12周达到稳定浓度,停药24周血清干扰素浓度仍略高于治疗前,而干扰素抗体浓度变化不大,二者无明显相关性.%Objective To detect serum interferon concentration and interferon antibody levels in chronic hepatitis B patients treated with pegylated interferon and its role in interferon efficacy. Methods Forty-one chronic hepatitis B patients were treated with pegylated interferon α-2a at a dose of 180 μg/week. Levels of serum interferon concentration and interferon antibody levels were detected by ELISA at weeks 0, 4, 12, 24 and 48, and the levels of serum interferon concentration were detected at 24 weeks off-treatment. Results The levels of serum interferon concentrations were 22. 9(3. 1-45. 8)pg/mL, 2 734(9. 2-4 224)pg/mL, 4 025(269-4 462)pg/mL, 3 884(14. 5-4 567)pg/mL, 3 978(76. 9-5 227)pg/mL and 62. 1 (52. 3-74. 6)pg/mL at weeks 0, 4, 12, 24, 48 and at 24 weeks off-treatment, respectively. Compared to the level of interferon concentration at week 0, there was statistically significant difference at weeks 4, 12, 24, 48 and at 24 weeks off-treatment (t = 9.481, P<0. 0; Z = -6. 862, P<0. 01 ; Z =-6. 969, P<0. 01; Z =-6. 477, P<0. 01; Z =-4. 204, P<0. 01). Compared to interferon concentration at week 4, there was statistically significant difference of the level at weeks 12 and 24 (Z=-4.316, P<0. 01; Z = -3.830, P = 0. 000 1). Compared to serum interferon concentration at week 12, there was no statistically significant difference at week 24(Z= 0. 367, P = 0. 713 6). Compared to serum level of IFN antibody at week 0, there was no statistically significant difference at weeks 4, 12, 24 and 48 (Z = -1. 035, P = 0. 300 7; Z = 0. 101, P = 0. 919 2; Z= 0. 158, P = 0. 874 8; Z = 1. 779, P = 0. 075 2). Conclusion The level of serum interferon concentration reached a steady concentration at week 12 with pegylated interferon α-2a therapy, and was still a little higher at 24 weeks off-treatment than that at week 0. The level of interferon antibody was not significantly changed at each time point, and it had no correlation with the level of interferon concentration.