α干扰素联合利巴韦林治疗儿童丙型肝炎患者病毒学应答率分析  

Virological and biochemical response in children with chronic hepatitis C by using peginterferon-α2a and ribavirin combination treatment

作　　者：符垂师 张杰伟 Fu Chuishi;Zhang Jiewei(Department of Paediatrics,First Affiliated Hospital,Hainan Medical College,Haikou 570102,Hainan Province,China)

机构地区：[1]海南医学院第一附属医院儿科,海口市570102 [2]海南医学院第一附属医院消化内科,海口市570102

出　　处：《实用肝脏病杂志》2020年第3期344-347,共4页Journal of Practical Hepatology

基　　金：海南省高等学校科学研究计划项目(编号:Hnky2017-33)。

摘　　要：目的探讨应用α-干扰素联合利巴韦林治疗儿童慢性丙型肝炎(CHC)患者的疗效和副反应。方法2016年4月~2018年4月在我院肝病科就诊的42例CHC患儿被随机分为对照组21例和观察组21例,分别接受重组干扰素α-1b或聚乙二醇干扰素α-2a联合利巴韦林治疗48周。观察病毒学和生化学应答率及不良反应情况。结果观察组快速病毒学应答、早期病毒学应答、治疗结束病毒学应答和持续病毒学应答率分别为38.1%、81.0%、90.5%和85.7%,显著高于对照组的16.7%、52.4%、69.1%和64.3%(P<0.05);在治疗4周、12周和48周时,聚乙二醇干扰素α-2a治疗组ALT复常率分别为59.5%、73.8%和83.3%,与对照组相比无统计学差异(分别为47.6%、69.0%和81.0%,P>0.05);聚乙二醇干扰素α-2a治疗组患儿流感样症状和外周血中性粒细胞数减少发生率显著高于国产干扰素治疗组(P<0.05)。结论聚乙二醇干扰素α-2a联合利巴韦林治疗儿童CHC近期疗效较好,但副反应较大,需要根据情况,及时处理,以保证治疗的顺利进行。Objective To explore the virological and biochemical response in children with chronic hepatitis C(CHC) by using peginterferon-α2a and ribavirin combination treatment. Methods 42 children with CHC were recruited in our hospital between April 2016 and April 2018,and were randomly divided into control(n = 21) and observation group(n = 21). The patients in control group were treated with recombinant interferon α-1b and ribavirin,while the children with CHC in observation group received peginterferon α-2a and ribavirin combination treatment,and the regimen lasted for 48 weeks. Results The rapid virological response,early virological response,virological response at the end of treatment and sustained virological response in peginterferon α-2a-treated children were 38.1%,81.0%,90.5% and 85.7%,significantly higher than 16.7%,52.4%,6 9.1%and 64.3%,respectively,in the control(P < 0. 05);serum ALT normalization rates at week 4,week 12 and week 48 in the observation group were 59. 5%,73. 8% and 83. 3%,not significantly different as compared to 47. 6%,69. 0% and 81. 0%,respectively,in the control(P>0.05);the incidence of influenza-like symptoms and neutropenia in the observation group were much higher than those in the control(P<0.05). Conclusion The combination of peginterferon α-2a and ribavirin in treatment of children with CHC is efficacious with improved virological response,but having some side effects,which should be dealt with in time to complete the regimen.

关 键 词：慢性丙型肝炎 聚乙二醇干扰素A-2A 重组干扰素a-1b 利巴韦林 病毒学应答 治疗 

分 类 号：R725.1[医药卫生—儿科]