个体化治疗转氨酶正常的慢性丙型肝炎73例  

An individualized strategy for treatment of hepatitis C virus carriers with normal aminotransferase levels: Analysis of 73 cases

作　　者：徐成军 张翠萍 王晓宏 刘丽君 周珊珊 王久恒 何秋杰 王云中 郭文山 朱万柏 江勇[2] 

机构地区：[1]承德市宽城满族自治县医院内二科,河北省承德市067600 [2]天津医科大学第二医院消化内科,天津市300211

出　　处：《世界华人消化杂志》2014年第16期2317-2322,共6页World Chinese Journal of Digestology

摘　　要：目的:评价聚乙二醇干扰素α-2a(polyethylene glycol interferon alpha-2a,PEG-IFNα-2a)联合利巴韦林(ribavirin,RBV)治疗转氨酶正常的慢性丙型肝炎(chronic hepatitis C,CHC)的临床疗效和安全性.方法:对转氨酶正常(18 mo至少有3次以上的化验结果证实转氨酶均在正常范围者)和升高的慢性丙型肝炎患者按照应答指导治疗策略给予PEG-IFNα-2a(180 g/wk)联合RBV(≤65kg 800 mg/d,>65 kg-<75 kg 1000 mg/d,≥75kg 1200 mg/d)治疗,并随访24 wk.分别于治疗4、12 wk及治疗结束后24 wk评价疗效,并观察药物不良反应.结果:共有161例患者完成治疗,其中73例实验组患者和88例对照组患者入组的基本情况相似.实验组和对照组的快速病毒学应答(78.1%vs 75.0%,P>0.05)、完全早期病毒学应答(93.2%vs 92.0%,P>0.05)和持续病毒学应答(92.7%vs 91.9%,P>0.05)相近,差异无统计学意义.结论:PEG-IFNα-2a联合RBV治疗转氨酶正常的CHC是安全有效的.AIM： To evaluate the efficacy and safety of peginterferon alpha-2a（PEG-IFN α-2a） combined with ribavirin（RBV） in the treatment of chronic hepatitis C（CHC） patients with normal aminotransferase levels. METHODS： Patients with CHC and at least three normal aminotransferase values over an18-month period or increased aminotransferase were offered a treatment with PEG-IFN α-2a 180 μg/wk and ribavirin（800 mg/d for weight ≤ 65 kg; 1000 mg/d for weight ＆gt; 65 and ＆lt; 75 kg; 1200 mg/d for weight ≥ 75 kg）. All patients were followed for 24 wk post treatment. Curative effects were evaluated at 4 and 12 wk during the treatment and 24 wk post treatment. The adverse effects were also recorded. RESULTS： A total of 161 patients completed the therapy. The 73 patients with normal transaminase and the 88 patients with increased transaminase had similar baseline characteristics. Overall, the two groups showed similar rapid virologic response（RVR） rate（78.1% vs 75.0%, P ＆gt; 0.05）, complete early virologic response（cEVR） rate（93.2% vs 92.0%, P ＆gt; 0.05） and sustained virologic response（SVR） rate（92.7% vs 91.9%, P ＆gt; 0.05）. CONCLUSION： Combination therapy with PEGIFN α-2a and RBV is safe and effective in CHC patients with persistently normal aminotransferase levels.

关 键 词：慢性丙型肝炎 聚乙二醇干扰素Α-2A 转氨酶 

分 类 号：R512.63[医药卫生—内科学]