聚乙二醇干扰素治疗儿童与成人慢性肝炎的不良反应对比研究  

Comparative Study on Adverse Reactions between Children and Adults in Treatment of Chronic Hepatitis by Peginterferon Alfa-2a

作　　者：唐红梅[1] 陈钫[2] 朱世殊[1] 董漪[1] 霍翠华[1] 

机构地区：[1]中国人民解放军302医院感染五科,北京市100039 [2]中国人民解放军307医院理疗科

出　　处：《中国全科医学》2011年第20期2303-2305,共3页Chinese General Practice

摘　　要：目的了解聚乙二醇干扰素治疗儿童与成人慢性肝炎的近期不良反应及程度,为儿童和成人抗病毒治疗提供客观依据。方法对聚乙二醇干扰素治疗的成人或儿童患者进行为期4周的观察,观察项目有体温、关节肌肉酸痛、头痛头晕等。结果在聚乙二醇干扰素治疗过程中,成人出现不良反应的种类较儿童多,但所占比例却较儿童低,其中体温升高、关节肌肉酸痛、头痛是儿童组与成人组共同的3大不良反应;聚乙二醇干扰素治疗中体温升高的程度在成人组以中热为主,儿童组在第1周时以低热为主,到第2周之后才以中热为主;注射聚乙二醇干扰素后,成人组与儿童组均多在3 h之后开始发热,体温升高多持续3~4 h,在注射后1周中大多数患者只发热1次;在体温升高的处理方面,成人在注射第1针时需要药物降温者的比率较儿童高,但机体适应能力和中枢体温调节能力较儿童强,从第2针开始,成人需要药物降温者的比率明显较儿童低。结论在聚乙二醇干扰素治疗的近期不良反应中,儿童组与成人组的表现不尽相同,其中体温升高、关节肌肉酸痛、头痛是儿童组与成人组共同的3大不良反应;发热多为一过性,部分成人与儿童均不需要进行处理;由于儿童和成人均采用逐渐增加聚乙二醇干扰素量的＂阶梯式＂加量法,其不良反应均在可控范围内。聚乙二醇干扰素抗病毒治疗在儿童和成人中均是安全、有效的。Objective To investigate the scope and degree of short-term adverse reactions of peginterferon alfa-2a in treatment of chronic hepatitis in children and adults to provide reference for anti-viral treatment in clinical practice.Methods A prospective study was conducted in children and adults with chronic hepatitis who were treated with peginterferon alfa-2a for 4 weeks.Body temperature,soreness in joints and muscles,headache and dizziness were observed.Results The adult group showed more types of adverse reactions than the child group.However,incidence of adverse reactions was lower in adults than in children.Increase of body temperature,soreness in joints and muscles,headache and dizziness were the 3 major adverse reactions in both children and adults.In adults,the increase of body temperature was mainly characterized by a moderate increase.In children,the increase of body temperature was slight during the first week and became moderate since the second week.Body temperature increased 3 hours after injection and lasted for 3-4 hours.Most patients experienced only one episode of fever during the first week after injection.As for management of the body temperature increase,the rate of drug requirment for temperature maintaining after the first injection was higher in adults than in children.However,the body adjusting capacity and modulating ability of the central nervous system were better in adults than in children.Therefore,the rate for drug requirment for temperature maintaining after the second injection was lower in adults than in children.Conclusion The short-term adverse reactions in patients with chronic hepatitis treated with peginterferon alfa-2a are different between children and adults.Increase of body temperature,soreness in joints and muscles,headache and dizziness are the 3 major adverse reactions in both adults and children.The fever is evanescent in most patients and no treatment is needed.Since the dose of peginterferon alfa-2a is added gradually in application,the adverse reactions are low in num

关 键 词：聚乙二醇干扰素 慢性肝炎 儿童 成人 不良反应 

分 类 号：R575.1[医药卫生—消化系统]