重组人干扰素α-2b联合利巴韦林在慢性丙型肝炎治疗中的疗效及外周血变化研究  

Effect of recombinant human interferon α-2b and ribavirin in the treatment of chronic hepatitis C and changes of peripheral blood

作　　者：陈凤娣 张郴华 李敏[1] 

机构地区：[1]广州医科大学附属第六医院/清远市人民医院,广东广州511500

出　　处：《中医临床研究》2018年第30期66-68,共3页Clinical Journal Of Chinese Medicine

摘　　要：目的:探讨联合应用重组人干扰素α-2b与利巴韦林治疗对慢性丙型肝炎治疗中的疗效及外周血变化的影响。方法:纳入我院2016年6月-2017年5月期间接受治疗的慢性丙型肝炎30例,10例HCV RNA定量<104 IU/mL,10例104～106IU/ml,10例> 106 IU/mL。HCV 1a型3例、1b型20例、2a型3例、2b型2例、3a型2例。采用重组人干扰素α-2b联合利巴韦林治疗,观察期为24周。空腹采集静脉血5 mL,采用荧光定量PCR方法检测HCV RNA病毒含量、血细胞分析采用血液分析仪分析,检测HCV基因型、病毒载量、外周血的变化对治疗效果的影响。结果:RNA基线<1×104 IU/mL的病毒应答率(SVR)显著高于104～106 IU/mL和≥106 IU/mL,差异有统计学意义(P <0.05),而104～106 IU/mL和≥106 IU/mL两者之间的SVR率差异无统计学意义(P> 0.05);1型HCV与非1型HCV的SVR率差异具有统计学意义(P <0.05);外周血:中性粒细胞、血小板计数、血红蛋白与治疗前比升高显著组SVR率明显高于与治疗前无明显升高组,差异有统计学意义(P <0.05)。结论:慢性丙型肝炎采用重组人干扰素α-2b联合利巴韦林治疗效果良好,疗效受多种因素影响,非1型HCV患者采用重组人干扰素α-2b与利巴韦林治疗可获得更佳的SVR效率,低病毒载量水平、外周血中性粒细胞、血小板计数、血红蛋白升高患者SVR率治疗效果更佳。Objective To investigate the efect of combined use of recombinant human interferon α-2b and ribavirin on the thera-peutic efect and peripheral blood change of chronic hepatitis C. Methods： Thirty patients with chronic hepatitis C who were treated in our hospital from June 2016 to May 2017 were included. Ten HCV RNA quantifcation were 〈104 IU/mL, 10 were 104 ~ 106 IU/ml, and 10 were 〉 106 IU/mL. There were 3 cases of HCV type 1a, 20 cases of type 1b, 3 cases of type 2a, 2 cases of type 2b, and 2 cases of type 3a. Recombinant human interferon α-2b was combined with ribavirin for an observation period of 24 weeks. 5ml of venous blood was collect-ed on an empty stomach. HCV RNA content was detected by fuorescence quantitative PCR. Blood cell analysis was performed using a blood analyzer. The efect of changes in HCV genotype, viral load, and peripheral blood on the therapeutic efect was examined. Results： The viral response rate （SVR） at RNA baseline 〈 1×104 IU/mL was signifcantly higher than 104 to 106 IU/mL and ≥ 106 IU/mL, and the diference was statistically signifcant （P 〈 0.05）, while 104 to 106 IU/mL and ≥ There was no signifcant diference in the SVR rate between 106 IU/mL （P 〉 0.05）; the diference in SVR rates between HCV type 1 and non-HCV type 1 was statistically signifcant （P〈 0.05）; Peripheral Blood： Neutrophils signifcantly higher SVR rates were found in patients with signifcantly elevated platelet counts, hemoglobin, and pretreatment than those with elevated pretreatment（P 〈 0.05）. Conclusion： The use of recombinant human interferon α-2b combined with ribavirin for chronic hepatitis C was efective, and the efcacy was afected by many factors. Non-type 1 HCV patients could be treated with recombinant human interferon α-2b and ribavirin. Better SVR efciency was achieved with lower levels of viral load, peripheral blood neutrophils, platelet counts, and higher hemoglobin SVR rates.

关 键 词：慢性丙型肝炎 重组人干扰素Α-2B 利巴韦林 外周血 中性粒细胞 血小板计数 血红蛋白 

分 类 号：R512.63[医药卫生—内科学]