慢性丙型肝炎患者标准化治疗应答的相关因素分析  

Multiple factor analysis of the efficacy of standard antiviral therapy in patients with chronic hepatitis C

作　　者：周明琴[1] 蒋素文[1] 胡爱荣[1] 胡耀仁[1] 丁世雄[1] 梁晓岳[1] 

机构地区：[1]宁波市第二医院肝病中心,浙江宁波315010

出　　处：《中华全科医学》2016年第2期240-242,共3页Chinese Journal of General Practice

基　　金：浙江省宁波市自然科学基金(2010A610075;2012-A610248)

摘　　要：目的探讨慢性丙型肝炎(CHC)标准化抗病毒治疗应答的影响因素,为临床提供参考价值。方法选择97例CHC患者,分别检测丙型肝炎病毒(HCV)基因型、HCV RNA和白细胞介素-28B(IL-28B)位点rs8099917基因型。患者均接受标准化抗病毒治疗。分析获得快速病毒学应答(RVR)、早期病毒学应答(EVR)、治疗结束时病毒学应答(ETVR)和持续病毒学应答(SVR)的影响因素。结果 HCV基因1型组和非1型组、rs8099917基因TT型组和GT+GG型组的RVR、EVR、ETVR和SVR差异具均有统计学意义(χ2=9.359、11.440、6.346、8.147、9.938、7.413、4.564和4.229,P<0.05)。获得RVR的独立影响因素为HCV基因非1型、高ALT和AST水平、低HCV RNA载量以及rs8099917基因TT型;获得EVR的独立影响因素为HCV基因非1型和低HCV RNA载量;获得ETVR的独立影响因素为高ALT水平;获得SVR的独立影响因素为HCV基因非1型、高ALT水平和rs8099917基因TT型。结论 HCV基因非1型、高ALT水平和rs8099917基因TT型是获得SVR的有利因素。Objective To investigate the influencing factors of the efficacy on virologic response of the standard antiviral therapy in patients with chronic hepatitis C （CHC） and to provide a reference value for clinical treatment. Methods The data of 97 patients with CHC were analyzed retrospectively. The conditions of hepatitis C virus （ HCV ） genotypes, HCV RNA,and rs8099917 genotypes in interieukin-28B （IL-28B） gene were determined, respectively. The patients were all given the standard antiviral therapy. The influencing factors of rapid virological response （RVR） , early virological response （EVR）, end-of-treatment virological response（ETVR） and sustained virological response（SVR） were compared and analyzed,respectively. Results The RVR,EVR,ETVR and SVR rates were significant differences in HCV genotype 1 group and in HCV non-genotype 1 group,in rs8099917 genotype TF group and in rs8099917 genotype GT ＋ GG group,respectively （ Х^2 = 9. 359,11. 440,6. 346,8. 147,9. 938,7.413,4. 564,4. 229 ; P 〈 0.05 ）. The independent impact factors of RVR were HCV non-genotype 1, high levels of ALT and AST,low HCV RNA level, and rs8099917 genotype TT;of EVR were HCV non-genotype 1 and low HCV RNA level ; of ETVR was high ALT level ; and of SVR were HCV non-genotype 1, high ALT level, and rs8099917 genotype TT. Conclusion HCV non-genotype 1, high ALT level, and rs8099917 genotype TT are important favorable factors for SVR in patients with CHC.

关 键 词：肝炎病毒 丙型 聚乙二醇干扰素 利巴韦林 病毒学应答 影响因素 

分 类 号：R512.63[医药卫生—内科学]