慢性丙型肝炎合并冷球蛋白血症患者抗病毒治疗后生存质量的变化  

Changes of quality of life after antiviral therapy in patients with chronic hepatitis C and cryoglobulinemia

作　　者：张建军[1] 李新华[2] 苏振宇[1] 曹春蕊[3] 

机构地区：[1]唐山市玉田县医院检验科,河北唐山064100 [2]唐山市玉田县医院感染疾病科,河北唐山064100 [3]石家庄市第五医院肝病七科,河北石家庄050051

出　　处：《中国临床研究》2016年第4期440-443,共4页Chinese Journal of Clinical Research

基　　金：河北省卫生和计划生育委员会医学科学研究重点课题计划项目(20151010)

摘　　要：目的探讨抗病毒治疗对慢性丙型肝炎（CHC）合并冷球蛋白血症患者生存质量（QOL）的影响。方法随机选取2009年2月至2014年10月在河北省玉田县医院及石家庄市第五医院就诊的CHC合并冷球蛋白血症75例患者的临床资料进行回顾性分析。以采用聚乙二醇干扰素α-2a联合利巴韦林抗病毒治疗的40例为治疗组,采用常规保肝治疗的35例为对照组,疗程48周。比较分析两组患者治疗前、治疗24、48周时生化、病毒学指标及慢性肝病问卷（CLDQ）评分的变化情况。结果 （1）治疗组治疗24、48周时ALT、TBIL值及HCV RNA载量低于对照组,ALB高于对照组,差异有统计学意义（P均〈0.05）。（2）治疗组治疗48周时冷球蛋白检出率为42.5%（17/40）,病毒学应答率（HCV RNA〈10~3拷贝/ml）为72.5%（29/40）;而对照组两者均无变化。（3）治疗组治疗48周时CLDQ评分均较治疗前明显提高,差异有统计学意义（P均〈0.05）,对照组治疗48周时腹部症状、全身症状评分较治疗前明显降低,差异具有统计学意义（P均〈0.05）;治疗组治疗24周时乏力评分明显高于对照组（P〈0.05）,但腹部症状、全身症状、活动、情感功能、焦虑评分差异不明显（P均〉0.05）,治疗48周时乏力、全身症状、活动、情感功能、焦虑评分明显高于对照组（P均〈0.05）,但腹部症状差异不明显（P〉0.05）。结论抗病毒治疗可以明显改善CHC合并冷球蛋白血症患者的生存质量。Objective To investigate the impact of antiviral treatment on the quality of life（ QOL） of patients with chronic hepatitis C（ CHC） complicated with cryoglobulinemia. Methods The retrospective analysis was performed on the data of75 CHC patients complicated with cryoglobulinemia,who were treated in Yutian County Hospital and Shijiazhuang Fifth Hospital from February 2009 to October 2014. The patients were divided into treatment group（ n = 40） and control group（ n = 35） according to therapeutic methods. The antiviral therapy treatment with peginterferon α-2a plus ribavirin was given in treatment group,and routine hepatoprotective treatment was given in control group. The treatment course was 48 weeks for all patients. Changes of virological index,biochemical index and chronic liver disease questionnaire（ CLDQ） score were compared and analyzed before treatment,and at 24-,48- week after treatment between two groups. Results（ 1） Compared with the control group,levels of alanine aminotransferase（ ALT）,total bilirubin（ TBIL）,hepatitis C virus RNA（ HCV RNA） load decreased significantly,and albumin（ ALB） increased significantly at 24-,48- week after therapy in the treatment group（ all P 〈 0. 05）.（ 2） At 48- week after treatment,the detection rate of cryoglobulin was 42. 5%（ 17 /40） and the virological response（ HCV RNA 〈 10^3 copies / ml） rate was 72. 5%（ 29 /40） in treatment group,while there were no changes in both of them in control group.（ 3） Compared with before treatment,all factors scores of CLDQ in treatment group significantly increased（ all P 〈 0. 05）,and the scores of abdominal symptoms and systemic symptoms in control group significantly decreased（ all P 〈 0. 05） at 48- week after treatment. At 24- week after treatment,fatigue score of treatment group was significantly higher than that of control group（ P 〈 0. 05）,and there were no significant differences in the scores of abdominal symptoms,systemic symptoms,activity,emotion

关 键 词：丙型肝炎 慢性 冷球蛋白血症 抗病毒治疗 聚乙二醇干扰素Α-2A 利巴韦林 慢性肝病问卷 

分 类 号：R512.63[医药卫生—内科学]