来迪派韦/索磷布韦对比艾尔巴韦/格拉瑞韦治疗基因1b型慢性丙型肝炎疗效分析  

Efficacy and safety of ledipasvir/sofosbuvir versus elbasvir/grazoprevir in treatment of genotype 1b chronic hepatitis C

作　　者：陈海艳 李晓峰[1] 童照威[1] 钟剑峰[1] 曾庆球 张宪山 王伟洪[1] Chen Haiyan;Li Xiaofeng;Tong Zhaowei;Zhong Jianfeng;Zeng Qingqiu;Zhang Xianshan;Wang Weihong(Department of Infectious Diseases,Huzhou Central Hospital,Huzhou 313000,Zhejiang Province,Chin)

机构地区：[1]湖州市中心医院感染科,313000

出　　处：《中华临床感染病杂志》2022年第2期119-124,共6页Chinese Journal of Clinical Infectious Diseases

基　　金：浙江省自然科学基金(Y17H100002)。

摘　　要：目的对比来迪派韦/索磷布韦(Ledipasvir/sofosbuvir,LDV/SOF)与艾尔巴韦/格拉瑞韦(Elbasvir/grazoprevir,EBR/GZR)治疗初治慢性丙型肝炎(Chronic hepatitis C,CHC)患者的临床疗效及安全性。方法回顾性分析2020年1月至2021年12月在湖州市中心医院诊治的143例基因1b型CHC初治患者临床资料,根据治疗方案的不同分为LDV/SOF组(n=74)和EBR/GZR组(n=69),比较两组患者治疗4、12周及停药后12周的病毒学应答情况,以及治疗前后的血清学和肝脏炎症指标等。采用SPSS 25.0软件对数据进行统计学分析。结果治疗4、12周及治疗结束后12周时,LDV/SOF组和EBR/GZR组的病毒学应答率分别为97.30%和98.55%,98.65%和100.00%,97.30%和98.55%,两组差异均无统计学意义(P>0.05)。治疗终点时,两组患者肝脏炎症指标丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转肽酶均明显低于治疗基线水平(Z=-7.470和-6.974,-9.757和-6.832,-3.578和-4.054,P<0.01);两组各项指标对比差异均无统计学意义(P>0.05)。两组患者的不良反应均轻微,无严重不良事件发生。结论LDV/SOF和EBR/GZR治疗基因1b型初治CHC患者均具有较好的临床疗效,耐受性良好。Objective To compare the clinical efficacy and safety of ledipasvir/sofosbuvir(LDV/SOF)and elbasvir/grazoprevir(EBR/GZR)in treatment of patients with chronic hepatitis C(CHC).Methods The clinical data of 143 patients with genotype 1b CHC treated in Huzhou Central Hospital from January 2020 to December 2021 were retrospectively analyzed,including 74 cases treated with LDV/SOF and 69 cases treated with EBR/GZR.The virological response after 4 and 12 weeks of treatment and 12wk after drug withdrawal was determined;and the serological and liver inflammation indexes before and after treatment in two groups were compared.SPSS 25.0 software was used for statistical analysis of the data.Results The virological response rates of the LDV/SOF group and EBR/GZR group were 97.30%and 98.55%,98.65%and 100.00%,97.30%and 98.55%after 4 and 12 weeks of treatment and 12 weeks after the end of treatment,respectively(all P>0.05).At the end of treatment,the liver inflammation indexes ALT,AST and GGT in the two groups were significantly lower than the baseline levels(Z=-7.470 and-6.974,-9.757 and-6.832,-3.578 and-4.054,P<0.01).Adverse reactions in both groups were mild,and no serious adverse events occurred.Conclusion Both LDV/SOF and EBR/GZR have good clinical efficacy in the treatment of genotype 1b CHC patients.And the patients are well tolerated.

关 键 词：丙型肝炎 慢性 基因1b型 直接抗病毒药物 来迪派韦/索磷布韦 艾尔巴韦/格拉瑞韦 

分 类 号：R512.63[医药卫生—内科学]