聚乙二醇化干扰素联合利巴韦林治疗慢性丙型肝炎的疗效及影响因素分析  

Analysis on the effects and influence factors of Peg-interferon combined with ribavirin in the treatment of patients with chronic hepatitis C

作　　者：陈志敏[1] 陈铿[1] 应若素[1] 向芳菲[1] 石裕明[1] 李慧慧[1] 刘惠媛[1] 

机构地区：[1]广州市第八人民医院肝病三科,广州市510060

出　　处：《中华实验和临床感染病杂志（电子版）》2014年第1期22-25,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：广东省医学科学技术研究基金(No.A2011494)

摘　　要：目的：分析聚乙二醇化干扰素（PegIFN）联合利巴韦林治疗对慢性丙型肝炎的疗效及影响因素。方法使用聚PegIFNα-2a（派罗欣180μg/周）联合利巴韦林（根据体重900～1200 mg/d）治疗60例慢性丙型肝炎患者，疗程48周。结果本研究60例慢性丙型肝炎患者中，HCV-Ⅰ型45例，占75%，非HCV-Ⅰ型15例，占25%。HCV-Ⅰ型和非HCV-Ⅰ型患者持续应答（SVR）率分别为60.0%和93.3%，差异具有统计学意义（χ2=6.162，P=0.013）；基线病毒载量，以HCV RNA定量1＆#215;106 IU/ml划分，HCV RNA高水平组和低水平组SVR分别为48.3%和77.3%，差异具有统计学意义（χ2=6.093，P=0.014）。治疗过程中获得快速病毒学应答（RVR）的病例获得SVR和未获得RVR的病例获得SVR的比率分别为84.6%和38.1%，差异具有统计学意义（χ2=9.690，P=0.002）。治疗过程中获得早期病毒学应答（EVR）的病例获得SVR和未获得EVR的病例获得SVR的比率分别为78.4%和11.1%，差异具有统计学意义（χ2=4.036，P=0.045）。结论慢性丙型肝炎患者的治疗过程中，病毒基因型、基线病毒载量以及治疗过程中是否获得RVR/EVR均可能影响治疗后的持续病毒学应答。Objective To analyze the clinical effects and the inlfuence factors of combination of peg-interferon （PegIFN） and ribavirin in the treatment of patients with chronic hepatitis C （CHC）. Methods Total of 60 patients with CHC received the combination therapy of pagasys （180 μg/week） and ribavirin （900-1200 mg/d） for 48 weeks. Results Among the 60 patients, 45 （75%） were HCV-genotype-Ⅰand 15 （25%） were non-HCV-genotype-Ⅰ, and the sustained virological response （SVR） rates were 60%and 93.3%, respectively （χ2=6.162, P=0.013）. The baseline of HCV RNA level was deifned by 1 ＆#215; 106 IU/ml, and the SVR rates of high and low serum HCV RNA level groups were 48.3%and 77.3%, respectively （χ2=6.093, P=0.014）. The SVR rates of rapid virological response （RVR） obtained group and non-RVR obtained group were 84.6%and 38.1%, respectively （χ2=9.690, P=0.002）. The SVR rates of early virological response （EVR） obtained group and non-EVR obtained group were 78.4%and 11.1%, respectively （χ2=4.036, P=0.045）. Conclusions The SVR of the combination treatment in CHC patients could be inlfuenced by the genotype, the baseline serum levels of HCV RNA and whether RVR/EVR obtained or not.

关 键 词：肝炎 丙型 慢性 聚乙二醇化干扰素 利巴韦林 疗效 

分 类 号：R512.63[医药卫生—内科学]