目的 探讨Peg-IFNα-2 a治疗CHB时外周血象变化的规律,评估外周血象变化规律对于治疗效果的影响.方法 收集就诊于地坛医院肝病二科应用Peg-IFN-2α治疗的慢性乙型病毒性肝炎患者1 000例,收集基线水平、治疗2周、4周、8周、12周、24周、36周、48周、治疗结束后12周、治疗结束后24周、治疗结束后48周患者血常规、肝功能、肾功能、甲状腺功能等常规指标,HBVDNA、HBsAg等指标并进行统计分析.结果 应用Peg-INAα-2a治疗的慢性乙型病毒性肝炎患者外周血细胞均于治疗第2周开始出现明显下降;②在慢性乙型病毒性肝炎患者中,HBeAg阴性者白细胞、中性粒细胞、血红蛋白大致在第8周下降至最低值;血小板8周后仍有缓慢下降,至第48周时下降至最低水平,各指标于停药后均开始恢复正常,停药48周时基本恢复至基线水平;HBeAg阳性患者白细胞、血红蛋白、血小板大致在第36 ~48周下降至最低值,中性粒细胞于第2周下降至最低值,各个指标均于停药后开始恢复,停药48周基本恢复至基线水平;③36周血红蛋白下降幅度> 13.64%对于HBV DNA的转阴有一定的预测作用,2周淋巴细胞降幅大于0.33%对于HBsAg清除有一定的预测作用.结论 外周血的变化规律对于应用Peg-IFNd-2a治疗慢性乙型病毒性肝炎时抗病毒治疗疗效有一定的预测作.
Objective To observe the changes of peripheral blood picture of CHB with Peg-IFN,and explored the relationship between the changes and decline of HBV DNA,clearance of HBsAg.Methods Patients with CHB treated with Peg-IFN α-2 a in the Second Division of Liver Disease in Beijing Ditan Hospital were monitored for blood routine examination and Liver function,kidney function,thyroid function of baseline and weeks 2,4,8,12,24,36,48,and weeks 12,24,and 48 after the end of treatment for chronic hepatitis B,and HBV DNA,HBsAg.Results The decrease of peripheral blood cells began to occur at week 2 of treatment.For CHB with HBeAg negative patients,white blood cells,lymphocyte,neutrophils,hemoglobin and platelets significantly decreased at 2 weeks,while a minimum value occurred at 48 weeks.The recovery was obvious at the end of treatment (48 weeks),and reached pre-treatment levels at 48 weeks after the end of treatment.For CHB with HBeAg positive patients,white blood cells,neutrophils,hemoglobin and platelets significantly decreased at 2 weeks,while a minimum value was found at 36-48 weeks.The recovery was obvious at the end of treatment (48 weeks),and reached pre-treatment levels at 48weeks after the end of treatment.For patients with CHB,hemoglobin declined by more thanl3.64% at 36th week,which means that the patient would have a predictive significance for decrease of HBV DNA,and drops of more than 0.33% at 2nd week means that the patient would have a predictive significance for clearance of HBsAg.Conclusions During the treatment with interferon,the variation regularity of blood picture for predicting result have a certain effect,which may help predict and monitor the change of blood picture in clinical work.