聚乙二醇干扰素α-2a联合利巴韦林治疗高病毒载量1b基因型丙型肝炎患者无病毒学应答的预测因素分析  

Predictive Factors of Non Viral Response in Patients with High Viral Load 1b Genotype of Hepatitis C Virus Treated with Ribavirin Combined with Interferon Alpha-2a

作　　者：陈亮[1] 耿庆山[1] 郑俊 

机构地区：[1]广东省人民医院广东省医学科学院华南理工大学第一临床学院医务科、心内科,广东广州510080 [2]广州市荔湾区人民医院急诊科,广东广州510100

出　　处：《标记免疫分析与临床》2016年第7期805-810,共6页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨聚乙二醇干扰素α-2a联合利巴韦林治疗高病毒载量1b基因型HCV患者无病毒学应答的预测因素。方法选取于2010年2月至2014年12月我院接受的聚乙二醇干扰素α-2a联合利巴韦林治疗的HCV基因1b型感染的慢性HCV初治患者72例。治疗3周后检测病毒学应答状态,无应答组患者23例,有应答组患者49例。回顾性统计患者的一般临床资料及相关指标,并做统计学分析。结果有应答组患者HCV病毒RNA水平及HCV病毒核心抗原水平均明显下降,在第1天到第14天的每个时间点上两组比较差异均具有统计学意义(P<0.001)。最高的HCV病毒RNA水平HCV病毒核心抗原水平曲线下面积均在第2周发生。第2周HCV病毒RNA消耗及耗损准确性均最高,其准确性与白细胞介素-28B minor+C区氨基酸70替代突变的准确性一致。结论从治疗开始后2周内的病毒动力学分析,特别是IL-28B基因多态性和病毒突变,2周时的病毒应答情况是最有效的无病毒学应答的预测因素。因此,在2周时病毒下降有可能作为重要的预测指标。Objective To investigate the predictive factors of non viral response in patients with high viral load 1b genotype of hepatitis C virus when treated with Ribavirin combined with interferon alpha -2a. Methods In our hospital from February 2010 to December 2014, 72 cases of chronic hepatitis C with HCV gene 1b, treated with Ribavirin combined with interferon alpha -2a. After 3 weeks of treatment, the patients were examined for the state of viral response. There were 23 patients with non response and 49 patients with response. Patient＇s clinical data was processed with statistical analysis. Results There was a significant decline in the level of HCV virus RNA and the level of HCV virus core antigen in the response group, and the difference was statistically significant between groups at each time point （P〈0.001） from day 2 to day 14. The area of the highest level of RNA HCV virus HCV virus core antigen levels was at week 2. HCV RNA consumption and HCV RNA loss at week 2 were the highest, which was consistent with interleukin prime alternative 28b minor＋C amino acid 70 mutations. Conclusion Virus decline at two weeks after treatment with Ribavirin combined with interferon alpha -2a was the most, which might be used as a good time point for detection of efficacy of treatment .

关 键 词：聚乙二醇干扰素Α-2A 利巴韦林 高病毒载量1b基因型HCV 无病毒学应答 

分 类 号：R512.63[医药卫生—内科学]