聚乙二醇干扰素α联合利巴韦林治疗难治性慢性丙型肝炎过程中血常规变化与疗效的相关性  

Correlation between routine blood test results and antiviral effect in patients with refractory chronic hepatitis C treated with pegylated interferon-α

作　　者：陈晓云[1] 郑艳红[1] 金怡[1] 于海滨[1] 马丽娜[1] 陈新月[1] 

机构地区：[1]首都医科大学附属北京佑安医院,北京100069

出　　处：《临床肝胆病杂志》2016年第7期1319-1322,共4页Journal of Clinical Hepatology

基　　金："十二.五"国家科技重大专项(2012ZX10002003-004-002)

摘　　要：目的观察难治性慢性丙型肝炎标准治疗过程中血常规的变化与抗病毒疗效的关系。方法收集2011年9月-2012年12月于首都医科大学附属北京佑安医院就诊的难治性慢性丙型肝炎初治患者63例,给予聚乙二醇干扰素α-2a(180μg/周)联合利巴韦林治疗48周,分别在基线、治疗4、12、24、48周和随访24周时进行HCV RNA及血常规的检测,分析血常规与疗效的相关性。根据是否获得持续病毒学应答(SVR),分为SVR组和n SVR组。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验;采用简单线性相关分析法进行相关性分析。结果 63例患者有3例失访,余下60例均完成抗病毒治疗和24周随访,其中46例获得SVR,SVR率为76.7%;SVR组患者治疗4、12、24周时的淋巴细胞计数(LYPH)、白细胞计数(WBC)及中性粒细胞计数(NUET)均低于n SVR组,并且在12周时差异均有统计学意义(t值分别为3.398、2.766、2.037,P值均<0.05),在24周时两组WBC及NUET差异亦均有统计学意义(t值分别为2.559、2.151,P值均<0.05);此外SVR组患者在治疗4周时上述3项指标较基线的下降幅度均大于n SVR组,其中LYPH下降幅度在两组间差异有统计学意义(t=2.26,P=0.03)。LYPH、WBC、NUET在治疗4、12周时与HCV RNA的下降幅度呈正相关(r值分别为0.36、0.45、0.37、0.47、0.61、0.33,P值均<0.05)。结论血常规中LYPH、WBC及NEUT的变化及下降幅度在一定程度上可作为难治性慢性丙型肝炎抗病毒疗效的预测指标。Objective To investigate the correlation between the changes in routine blood test results and antiviral effect in patients with refractory chronic hepatitis C receiving standard treatment. Methods A total of 63 previously untreated patients with refractory chronic hepatitis C who visited Beijing You An Hospital,Capital Medical University,from September 2011 to December 2012 were enrolled. The patients were treated with pegylated interferon- α- 2a 180 μg / week and ribavirin（ RBV） for 48 weeks. HCV RNA measurement and routine blood tests were performed at baseline and weeks 4,12,and 24 of treatment to analyze the correlation between routine blood test results and antiviral effect. According to the status of sustained virologic response（ SVR）,the patients were divided into SVR group and n SVR group. The t- test was used for comparison of continuous data between groups,the chi- square test was used for comparison of categorical data between groups,and a simple linear correlation analysis was performed. Results Of the 63 patients,three were lost to follow- up,and the other 60 patients completed the antiviral therapy and 24- week follow- up; among the 60 patients,46 achieved SVR,resulting in an SVR rate of76. 7%. Compared with the n SVR group,the SVR group showed lower absolute lymphocyte count（ LYPH）,white blood cell count（ WBC）,and absolute neutrophil count（ NUET）,and the three indicators were significantly different between the two groups at 12 weeks（ t = 3. 398,2. 766,and 2. 037,all P〈0. 05）; WBC and NUET still showed significant differences between the two groups at 24 weeks（ t = 2. 559 and 2. 151,both P〈0. 05）. In addition,at week 4 of treatment,the SVR group showed significantly greater reductions in these three indicators from baseline compared with the n SVR group,LYPH showed significant different between the two groups（ t = 2. 26,P =0. 03）. At weeks 4 and 12 of treatment,LYPH,WBC,and NEUT were positively correlated with the reduction in HCV RNA（ r = 0. 36,0. 45,0. 37,

关 键 词：肝炎 丙型 慢性 干扰素Α-2A 淋巴细胞计数 中性白细胞 白细胞计数 

分 类 号：R512.63[医药卫生—内科学]