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  

Study on the efficacy and influencing factors of Peg-interferon combined with ribavirin in treatment of patients with chronic hepatitis C

作　　者：李文全[1] 李廷东[1] 聂双全[1] 鲜龚兵 

机构地区：[1]四川省宜宾市第二人民医院传染科,四川宜宾644000

出　　处：《临床和实验医学杂志》2016年第5期456-459,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的观察并分析聚乙二醇化干扰素（Peg IFNα-2α）联合利巴韦林治疗慢性丙型肝炎的疗效及其影响因素。方法回顾性分析2010年1月至2015年1月期间收治的256例慢性丙型肝炎患者的临床资料,均予Peg IFNα-2α（180μg/周或135μg/周）联合利巴韦林900~1 200 mg/d抗病毒治疗48~72周,随访24周。比较不同基因分型病毒性学应答率;比较不同丙氨酸氨基转移酶（ALT）水平与病毒学应答率的关系;观察慢性丙型肝炎患者病毒载量与疗效之间的关系。结果 256例患者中,获得快速病毒学应答率（RVR）166例（64.8%）,早期病毒学应答率（EVR）243例（94.9%）和持续病毒学应答率（SVR）218例（85.2%）;基因分型结果显示,157例基因1型（61.3%）与99例非1型（38.7%）感染者中SVR分别为83.4%和81.8%,两组比较差异无统计学意义（P〉0.05）;按治疗前ALT水平分为高ALT水平组（ALT〉80 U/L）与低ALT水平组（ALT≤80 U/L）,两组之间RVR、EVR及SVR无显著差异（P〉0.05）;按HCV RNA基线水平,高病毒载量组（HCV RNA〉4×105IU/ml）RVR、ETVR和SVR均较低病毒载量组（HCV RNA≤4×105IU/ml）低,差异均有统计学意义（P〈0.05,P〈0.01）;按是否获得SVR分为SVR组与非SVR组,非SVR组的年龄及病程明显高于SVR组,差异有统计学意义（P〈0.01）。结论 Peg IFNα-2α联合利巴韦林治疗慢性丙型肝炎能获得较高的EVR和SVR,年龄、病程及治疗前HCV RNA水平均是影响SVR的重要因素。Objective To explore the efficacy of Peg- interferon（ Peg IFNα- 2α） combined with ribavirin in treatment of patients with chronic hepatitis C（ CHC） and its influencing factors. Methods The clinical data of 256 patients with CHC were retrospectively analyzed. These patients with CHC were treated by Peg IFNα- 2α（ 180 μg / week or 135 μg / week） plus ribavirin（ 900 to 1 200 mg / d） for 48 to 72 weeks,and all patients were followed up for 24 weeks after treatment. The difference in relationship between serological response rate of different genotyping of virus and different levels of alanine aminotransferase（ ALT） was compared; and the relationship between viral load and efficacy of patients with chronic hepatitis C had been observed. Results Among 256 patients,the rates of rapid virological response（ RVR）,early virological response（ EVR） and sustained virological response（ SVR） were 64. 8%,94. 9% and 85. 2% respectively. Among the genotypes of these 256 patients,HCV genotype- 1 was seen in 157 patients（ 61. 3%） and non- genotype 1 in 99 patients（ 38. 7%）,and the rates of SVR were 83. 4% and 81.8% respectively,and the difference between these 2 groups was not statistically significant. These 256 patients were divided into two groups according to the level of ALT before treatment： high ALT level group and low ALT level group,and the difference among RVR,EVR and SVR in these two groups was not significant（ P〉0. 05）. According to the load of HCV RNA before treatment,RVR,ETVR and SVR in high HCV RNA load group（ HCV RNA 4 × 105 IU / ml） were lower than those of low HCV RNA load group. Patents in non- SVR group were older in age and longer course of illness than those of patients in SVR group. Conclusion The efficacy of combination treatment in CHC patients can be influenced by their age,course of illness and level of HCV RNA.

关 键 词：丙型病毒性肝炎 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]