重叠丙型肝炎病毒感染对慢性乙型肝炎患者免疫调节剂泰来肽治疗的影响与对策  

Effects of Hepatitis C Virus Superinfection on Efficacy of Tailai Polypeptide (Antihepatitis B Placental Polypeptide) Treatment of Patients with Chronic Hepatitis B and its Prevention and Treatment Countermeasures

作　　者：商庆华[1] 于建国[1] 肖德明[2] 张学平[1] 安永[1] 徐传镇[1] 张光曙[1] 

机构地区：[1]解放军第88医院济南军区肝病研究所,山东泰安271000 [2]泰安市中心医院感染科,山东泰安271000

出　　处：《临床军医杂志》2002年第3期25-28,共4页Clinical Journal of Medical Officers

摘　　要：目的　观察重叠丙型肝炎病毒 (HCV)感染对慢性乙型肝炎 (CHB)患者应用免疫调节剂泰来肽治疗疗效的影响 ,并探讨防治措施。方法　选择应用免疫调节剂泰来肽治疗的重叠 HCV感染的 CHB患者 96例 (其中 48例 4ml,每日 1次 ,肌注 ,疗程 4月 ;48例 6ml,每日 2次 ,肌注 ,疗程 4月 )并与未重叠 HCV感染的 CHB患者 48例 (4 ml,每日 1次 ,肌注 ,疗程 4月 )进行对比。两组患者在年龄、性别、病程、肝脏损害等方面具有可比性 ,且血清 HBs Ag,HBe Ag,HBV-DNA均阳性 ,ALT异常。结果　重叠 HCV感染患者治疗结束时 ALT复常率 ,HBe Ag、HBV-DNA转阴率 ,血清 HBV-DNA含量变化均显著低于未重叠感染者 (P<0 .0 5 ) ;加大剂量后 ALT复常率 ,HBe Ag、HBV-DNA、HCV-RNA阴转率 ,血清 HBV-DNA含量变化均显著提高 (P<0 .0 5 )。结论　重叠 HCV感染降低 CHB免疫调节剂泰来肽治疗的疗效。对 CHB患者应尽量避免输血与血制品以防止 HCV感染。加大免疫调节剂泰来肽治疗剂量 ,对重叠 HCV感染的Objective To observe the effect of hepatitis C virus(HCV)superinfection on the efficacy of Tailai polypeptide(anti hepatitis B placental polypeptide)treatment of patients with chronic hepatitis B(CHB)and explore its prevention and treatment countermeasures Methods Ninety six, 48 CHB patients with and without HCV superinfection were enrolled in this study, respectively All patients were treated with Tailai polypeptide for 4 months Forty eight, 48 CHB patients with and without HCV superinfection were given Tailai polypeptide 4 ml im qd (the routine dose group), whereas 48 CHB patients with HCV superinfection were given it 6 ml im bid (the high dose group) The CHB patients with and without HCV superinfection were comparable in their age, sex, course of disease and liver lesions and they had serum positive of HBsAg, HBeAg, HBV DNA and ALT abnormality Then the rate of ALT normality, HBeAg, HBV DNA disappearance and the amount changes of serum HBV DNA at the completion of therapy from CHB patients with HCV superinfection were compared with those of patients without HCV superinfection Results The rate of ALT normality, HBeAg, HBV DNA disappearance and the amount changes of serum HBV DNA in CHB patients with HCV superinfection were lower than those of patients without HCV superinfection in the routine dose group( P <0.05), whereas the results of the above mentioned parameters from the high dose group were higher than those of the routine dose group in CHB patients with HCV superinfection( P <0.05) Conclusion HCV superinfection impairs the efficacy of Tailai polypeptide treatment of patients with CHB High dose Tailai polypeptide is a well treatment countermeasure for CHB patients with HCV superinfection It is necessary for patients with CHB to avoid receiving the blood and blood products transfusion as possible as for preventing HCV superinfection

关 键 词：丙型肝炎病毒 慢性乙型肝炎 重叠感染 泰来肽 防治对策 

分 类 号：R512.605[医药卫生—内科学]