贵州某地由同一名献血员所致慢性丙型肝炎患者抗病毒治疗的疗效观察  

Investigation of antiviral efficacy in patients with chronic hepatitis C originating from a same blood donor in Guizhou Province

作　　者：刘三都 程明亮[2] 贾继东[3] 杨庆坤 舒德云 穆茂[2] 

机构地区：[1]贵州省黔南州人民医院感染科,558000 [2]贵阳医学院附属医院感染科 [3]首都医科大学附属北京友谊医院肝病中心

出　　处：《中华传染病杂志》2013年第11期654-657,共4页Chinese Journal of Infectious Diseases

基　　金：贵州省省长资金西医临床重点应用课题项目（2012[124]-31号）

摘　　要：目的 观察采用普通IFN联合利巴韦林（RBV）标准疗法治疗由同一名献血员所致慢性丙型肝炎（CHC）患者的疗效.方法 普通IFN治疗组纳入65例由同一名献血员所致慢性丙型肝炎患者,隔天给予普通IFN-α 2b 300万～500万U,同时联合600～1000 mg/d RBV治疗;聚乙二醇干扰素（PEG-IFN）对照组纳入同期贵州省黔南州人民医院感染科就诊的CHC患者32例,给予PEG-IFN-α 2a 180 μg,每周1次,联合600～1000mg/d RBV治疗;疗程均为48周,随访96周.以持续病毒学应答（SVR）率、早期病毒学应答（EVR）率、治疗结束时病毒学应答（ETVR）率、停药后生物化学应答率为考核指标,同时观察药物不良反应.数据分析采用x2检验.结果 普通IFN治疗组SVR率为83.1％（54/65）,EVR率为93.8％（61/65）,ETVR率为86.2％（56/65）,停药后生物化学应答率为100.0％.PEG-IFN对照组SVR率为87.5％（28/32）,EVR率为96.9％（31/32）,ETVR率为90.6％（29/32）,停药后生物化学应答率为100.0％.两组患者SVR率比较差异无统计学意义（x2 =0.072,P=0.086）.但将两组患者按病毒载量分成HCV RNA＜ 1.0×106拷贝/mL和≥1.0×106拷贝/mL亚组,普通IFN治疗组的SVR率分别为88.9％和54.5％（x2=7.67,P=0.008）;PEG-IFN对照组的SVR率分别为96.0％和57.1％（x2=4.41,P=0.038）,低病毒载量组SVR率高于高病毒载量组.PEG-IFN对照组WBC和PLT减少的发生率高于普通IFN治疗组（x2=9.805,P=0.003;x2 =6.643,P=0.009）.结论 普通IFN-α 2b联合RBV治疗CHC患者的疗效与PEG-IFN-α 2a相似,但不良反应发生率低.Objective To investigate the antiviral efficacy of standard treatment with interferon （IFN）-α 2b and ribavirin （RBV） in patients with chronic hepatitis C （CHC） originating from a same blood donor.Methods The test group consisted of 65 CHC patients originating from a same blood donor,and was treated with IFN-α 2b 3-5 MU every other day in combination with RBV 0.6-1.0 g/d.Meantime,the control group consisted of 32 CHC patients who visited the Department of Infectious Diseases in Qiannan People＇s Hospital,and was treated with Peg-interferon （PEG-IFN）-α 2a 180 μg every week in combination with RBV 0.6-1.0 g/d.All the patients in the two groups were treated for 48 weeks and followed up for 96 weeks.Assessment indictors included sustained virological response （SVR）,early virological response （EVR）,end of treatment virological response （ETVR）,biochemical response after withdrawal of treatment.Side effects during treatment were also evaluated.Measurement data were analyzed by x2 test.Results In test group,SVR rate was 83.1% （54/65）,EVR rate was 93.8% （61/65）,ETVR rate was 86.2% （56/65） and biochemical response rate after withdrawal of treatment was 100.0%.In control group,SVR rate was 87.5% （28/32）,EVR rate was 96.9 % （31/32）,ETVR rate was 90.6 % （29/32） and biochemical response rate after withdrawal of treatment was 100.0 %.SVR rates of the two groups were not significantly different （x2 =0.072,P=0.086）.Patients of the two groups were divided into two subgroups according to viral load：hepatitis C virus （HCV） RNA〈1.0 × 106 copy/mL and HCV RNA≥1.0 × 106 copy/mL.SVR rates of patients with low and high viral load in test group were 88.9% and 54.5%,respectively （x2=7.67,P=0.008）,those in control group were 96.0% and 57.1%,respectively （x2 =4.41,P=0.038）.SVR rates were higher in the subgroup of patients with low viral load.Leukopenia and thrombocytopenia were more common in control group than in test group （x2 =9.805,P =0.003 ; x2 =6.643,P=0.0

关 键 词：干扰素Α-2B 聚乙烯二醇类 利巴韦林 肝炎病毒属 肝炎 丙型 慢性 病毒载量 

分 类 号：R512.62[医药卫生—内科学]