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慢性病毒性肝炎研究进展
引用本文:丁桂凤.慢性病毒性肝炎研究进展[J].生理科学进展,2002,33(3):239-244.
作者姓名:丁桂凤
作者单位:北京大学医学部免疫学系,北京100083
摘    要:近年,慢性病毒性肝炎研究领域有较大进展,慢性乙型肝炎病毒(HBV)感染,虽然有了应用广泛、历史较久、且效果较好的疫苗,但迄今仍是世界范围肝硬化和肝癌的主要诱因。传染途径可经产道、性接触和非肠道途径(包括静脉吸毒、血制品等)。成年病人有少有变慢性,但一岁以下患儿90%变成慢性肝炎。慢性肝损伤的临床表现可以是轻微的炎症重到晚期肝硬化,程度不等。α干扰素(IFNα)是治疗活动性肝炎的产宰药物,单核苷酸类药物(lamivudine和adefovir)也具有同样的疗效。晚期肝病和肝癌患者可进行移植,但异常伴发移植物的感染。乙型肝炎免疫球蛋白和新型抗病毒药物联合应用,可降低移植物感染的严重性。丙型肝炎病毒(HCV)在20世纪后期感染了大约1%的世界人口。这中RNA病毒非经口传播,绝大多数病人变成慢性肝炎,约20%逐渐演变成肝硬化或肝癌。用IFNα和病毒唑(Ribavirin)联合治疗,约40%病人的病理表现有所改善。肝移植对某些病例是适宜的,但移植物感染仍是悬而未决的问题,新发现的庚型肝炎病毒(HGV)和TT病毒目前认为并不引起严重的肝损害。

关 键 词:慢性病毒性肝炎  研究进展  肝硬化  干扰素α

Advances in Chronic Viral Hepatitis Studies
DING Gui,Feng.Advances in Chronic Viral Hepatitis Studies[J].Progress in Physiological Sciences,2002,33(3):239-244.
Authors:DING Gui  Feng
Abstract:Recently, significant advances were achieved in the field of chronic viral hepatitis studies, suggesting that an update on chronic hepatitis is timely. Chronic hepatitis B virus infection remains a significant worldwide cause of liver cirrhosis and hepatocellular carcinoma. Transmission occurs via perinatal, sexual, and parenteral routes (particularly intravenous drug abuse and also blood products). Infected adult cases rarely develop chronic hepatitis, but in children under 1 year, 90% develop chronic hepatitis. The clinical spectrum of chronic liver injury ranges from mild inflammation to end stage liver cirrhosis. Interferon alfa has been the mainstay of treatment for patients with active disease but nucleoside analogues (lamivudine and adefovir) are now available with similar efficacy. Patients with end stage liver disease and hepatocellular carcinoma can be offered transplantation, but infection in the graft is commonplace. The combination of hepatitis B immunoglobulin and newer antiviral drugs significantly reduce the incidence and severity of graft infection.The hepatitis C virus now affects more than 1% of populations worldwide. This RNA virus is spread parenterally.The majority of patients develop chronic hepatitis, which may be progressive, evolving to significant liver disease (cirrhosis or hepatocellular carcinoma) in about 20% cases after decades. Treatment with the combination of interferon alfa and ribavirin is successful in up to 40% cases. The newer "hepatitis" viruses G and TT do not cause significant liver injury.
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