干扰素治疗白细胞减少慢性丙型肝炎患者疗效观察  

The curative effect observation of pegylated interferon a-2b treatment chronic hepatitis C with white blood cells reduction

作　　者：高晓红[1] 东冰[1] 丁锋[1] 屈军校[1] 任迎全[1] 王台[1] 赵培东[1] 

机构地区：[1]延安大学附属医院感染科,陕西延安716000

出　　处：《中西医结合肝病杂志》2015年第2期77-79,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：延安市科学技术研究发展计划项目(No.2012KW-25)

摘　　要：目的:观察聚乙二醇干扰素α-2b(pegylated interferonα-2b,Peg-IFNα-2b)分层方法治疗白细胞(WBC)减少慢性丙型肝炎(CHC)的临床疗效。方法:将入组的105例患者分为3组,均使用保肝降酶药物,A组患者初始加用Peg-IFNα-2b,50μg,1次/周,B组患者初始加用普通干扰素α(IFN-α)1MU/次,1次/隔日,均皮下注射。两组患者均同时口服利巴韦林300mg/次,3次/d。根据患者反应,逐渐加大IFN剂量,密切监测血常规及不良反应,必要时采用辅助升白细胞药物。最后Peg-IFNα-2b达到80μg/次,1次/周,IFNα达到3MU/次,1次/隔日。C组患者仅使用保肝降酶药物。疗程1年。结果:在治疗1年时A、B、C 3组患者组ALT分别为(34±22)U/L、(67±44)U/L、(154±58)U/L,AST分别为(40±12)U/L、(79±32)U/L、(139±86)U/L;透明质酸(HA)分别为(48.13±30.21)μg/L、(89.34±76.42)μg/L、(201.34±106.21)μg/L,层粘蛋白(LN)分别为(102.1±79.52)μg/L、(239±87.54)μg/L、(536.68±358.35)μg/L,A、B组显著低于C组(P<0.05),A组显著低于B组(P<0.05);腹水出现率分别为0、0、10%;门静脉宽≥1.3cm比率分别为0、3.85%、10%;脾厚>4cm比率分别为4.34%、7.69%、16.67%,A、B组显著低于C组(P<0.05),A组显著低于B组(P<0.05);丙型肝炎病毒核糖核酸(HCV RNA)<1000IU/ml比率分别为91.30%、59.61%、0;WBC>3.0×109/L比率分别为91.30%、59.61%、0,A、B组显著高于C组(P<0.05),A组显著高于B组(P<0.05)。结论:白细胞减少的CHC患者可予干扰素抗病毒治疗。Objective：To investigate the clinical efficacy of pegylated interferon a-2b （Peg-IFNα-2b） treatment of white blood cells less than 3.0X10 9 /L repeatedly elevated transaminase in patients with chronic hepatitis C.Methods：105 patients were divided into three groups, three groups of patients the use of protecting liver and reducing enzyme drugs.Group A with initial plus PEG-interferon α-2b（Peg-IFNα-2b） 50 μg once a week,group B with IFN-αplus the initial 1MU, 1 every other day, subcutaneous injection of started applications.The two groups were using the Ribavirin 900mg/day application.Based on the reaction of patients, the dose increase gradually, close monitoring of blood routine,and other adverse reactions, increasing leukocyte drug assistance when necessary.Finally Peg-IFNα-2b reached 80μg once a week, IFN-αto 3MU 1 every other day, subcutaneous injection.Observation of 1 years. Result：In the 1 year treatment A, B, C group in glutamic-pyruvic transaminase（ ALT ）were （34 ±22） U/L, （67 ±44） U/L, （154 ±58） U/L.Glutamic-oxalacetic transaminase（ AST ） were （40 ±12） U/L, （79 ±32） U/L, （139 ±86） U/L.Hyaluronic acid（HA） respectively （48.13 ±30.21） μg/L, （89.34 ±76. 42） μg/L, （201.34 ±106.21） μg/L.Laminin （LN ）were （102.1 ±79.52） μg/L, （239 ±87.54） μg/L, （536.68 ±358.35） μg/L. Group A and B Were significantly lower than that of group C（P 〈0.05）, group A was significantly lower than that of group B（P 〈0.05）. The ascites proportion were 0, 0, 10%.Portal vein width≥1.3cm ratio were 0、3.85%、10%.Ratio of spleen thickness 〉4cm were 4. 34%,7.69%,16.67%.Group A and B were significantly lower than that of group C（P 〈0.05）, group A was significantly lower than that of group B（P 〈0.05）.Ratio of hepatitis C virus ribonucleic acid （HCV RNA） 〈1000IU/ml were 91.30%,59.61%,0 and the proportion of white blood cell （ WBC） 〉3.0 ×10 9 /L were 91.30%,59.61%,0.Group A and B were significantly hig

关 键 词：肝炎 丙型 慢性 聚乙二醇干扰素α-2b/治疗应用 干扰素α(IFNα)/治疗应用 白细胞减少 

分 类 号：R512.63[医药卫生—内科学]