血小板减少对干扰素治疗慢性乙型肝炎患者疗效的影响  

Influence of thrombocytopenia on interferon treatment for patients with chronic hepatitis B

作　　者：马保凤[1] 王千钧[1] 史昌河[1] 

机构地区：[1]青岛市传染病医院,青岛市266033

出　　处：《中华实验和临床感染病杂志（电子版）》2013年第2期44-47,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的探讨慢性乙型肝炎患者自然病程中血小板计数动态变化和血小板减少对干扰素治疗慢性乙型肝炎疗效的影响。方法对37例血小板减少的慢性乙型肝炎患者血小板计数变化进行4周的连续观察,对187例干扰素治疗的慢性乙型肝炎患者临床资料进行回顾性分析,分析治疗前血小板减少对干扰素停药或减量的相对风险性及对病毒学应答和血清学应答的影响。结果伴有血小板减少的慢性乙型肝炎患者4周内血小板计数无明显变化;治疗前血小板减少患者干扰素停药或减量发生率为40.5%(17/42),其危险性约为非血小板减少患者的2.5倍;但两组持续病毒学应答和持续血清学应答无明显差异。结论慢性乙型肝炎患者自然病程中血小板计数无显著改变;血小板减少患者的干扰素治疗限制性高于非血小板减少患者,但对持续病毒学应答和持续血清学应答无显著影响。Objective To investigate the sequential changes of platelet count and the impact of thrombocytopenia on interferon antiviral therapy in patients with chronic hepatitis B. Methods Changes of platelet count in 37 patients were examined during a 4-weeks follow-up. The impact of thrombocytopenia before interferon treatment on risk of discontinuation or reduction of interferon dosage and virological response and serological response were evaluated in 187 patients with chronic hepatitis B and treated with interferon, retrospectively. Results No significant changes of platelet count were observed in hepatitis B patients with thrombocytopenia during the following-up duration. The rate of discontinuation or reduction of interferon dosage was 40.5% in patients with thrombocytopenia. Risk of discontinuation or dose reduction was 2.5-times higher in patients with thrombocytopenia than in those without thrombocytopenia. End-of- treatment virological response rate in patients with thrombocytopenia was lower than that of those without thrombocytopenia, while there was no significant difference in sustained virological response rate or sustained serological response rate between the two groups. Conclusions There is no significant variation in the short-term natural course of platelet count in patients with chronic hepatitis B. Patients with pre-treatment thrombocytopenia borne more thrombocytopenia-related limitations in interferon therapy, but with no negative influence on of sustained virological and serological response.

关 键 词：血小板减少 干扰素 肝炎 乙型 慢性 药物治疗 

分 类 号：R512.62[医药卫生—内科学]