艾尔巴韦/格拉瑞韦治疗基因1b型慢性丙型肝炎患者疗效研究  

Response to elbavir/glarevir antiviral therapy in patients with genotype 1b chronic hepatitis C

作　　者：许海玲[1] 秦刚[3] 薛红[2] 章颖[2] Xu Hailing;Qin Gang;Xue Hong(Division One,Department of Liver Diseases,Third Hospital Affiliated to Nantong University,Nantong 226006,Jiangsu Province,China)

机构地区：[1]南通市第三人民医院、南通大学附属南通第三医院肝病一科,江苏省南通市226006 [2]南通市第三人民医院、南通大学附属南通第三医院重症感染病科,江苏省南通市226006 [3]南通市第三人民医院、南通大学附属南通第三医院附属医院感染病科,江苏省南通市226006

出　　处：《实用肝脏病杂志》2022年第6期788-791,共4页Journal of Practical Hepatology

基　　金：江苏省科技厅科研基金资助项目(编号:BE2015655)。

摘　　要：目的探讨应用艾尔巴韦/格拉瑞韦治疗基因1b型慢性丙型肝炎(CHC)患者的疗效。方法2018年6月~2020年12月我院收治的68例基因1b型CHC患者,被随机分为观察组34例和对照组34例,分别给予艾尔巴韦/格拉瑞韦或利巴韦林联合聚乙二醇干扰素α-2a治疗24 w,随访24 w。采用ELISA法检测血清L-选择素、C反应蛋白(CRP)、白细胞介素6(IL-6)和肿瘤坏死因子-α(TNF-α)。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70.6%、91.2%、97.1%和94.1%,显著高于对照组的41.2%、55.9%、64.7%和55.9%(P<0.05);在治疗4 w、12 w、24 w和随访24 w时,观察组血清HCV RNA水平分别为(1.5±0.9)lgIU/mL、(1.6±0.7)lgIU/mL、(1.2±0.6)lgIU/mL和(1.2±0.4)lgIU/mL,显著低于对照组【分别为(4.3±0.8)lgIU/mL、(4.7±0.9)lgIU/mL、(3.2±0.5)lgIU/mL和(3.2±0.5)lgIU/mL,P<0.05】;在治疗24 w结束时,观察组血清L-选择素、CRP、IL-6和TNF-α水平分别为(816.3±161.4)ng/mL、(13.7±1.9)ng/L、(84.4±18.8)pg/mL和(1.2±0.3)ng/mL,显著低于对照组【分别为(1157.4±192.3)ng/mL、(16.3±2.0)ng/L、(115.9±20.5)pg/mL和(1.6±0.3)ng/mL,P<0.05】;观察组外周血白细胞计数、血小板计数和血红蛋白水平分别为(5.4±1.1)×10^(9)/L、(101.3±17.3)×10^(9)/L和(120.8±19.5)g/L,显著高于对照组【分别为(3.2±0.8)×10^(9)/L、(86.9±16.6)×10^(9)/L和(101.6±16.2)g/L,P<0.05】。结论应用艾尔巴韦/格拉瑞韦治疗基因1b型CHC患者疗效好,副作用少,可能与抑制了机体炎症反应有关。Objective This study was aimed at exploring the response to elbavir/glarevir antiviral therapy in patients with genotype 1b chronic hepatitis C(CHC).Methods 68 patients with genotype 1b CHC were recruited in our hospital and were divided into observation(n=34)and control(n=34)group,receiving elbavir/glarevir or ribavirin and peg-interferonα-2a combination therapy for 24 weeks.All the patients were followed-up for 24 weeks.Serum L-selectin,C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels were detected by ELISA.Results The rapid virological response,early virological response,end-of-treatment response and sustained virological response in the observation group were 70.6%,91.2%,97.1%and 94.1%,all much higher than 41.2%,55.9%,64.7%and 55.9%(P<0.05)in the control;at the end of 4,12,24 week treatment and 24 week follow-up,serum HCV RNA loads in the observation group were(1.5±0.9)lgIU/mL,(1.6±0.7)lgIU/mL,(1.2±0.6)lgIU/mL and(1.2±0.4)lgIU/mL,significantly lower than[(4.3±0.8)lgIU/mL,(4.7±0.9)lgIU/mL,(3.2±0.5)lgIU/mL and(3.2±0.5)lgIU/mL,respectively,P<0.05]in the control;at the end of 24 week treatment,serum L-selectin,CRP,IL-6 and TNF-αlevels in the observation group were(816.3±161.4)ng/mL,(13.7±1.9)ng/L,(84.4±18.8)pg/mL and(1.2±0.3)ng/mL,all significantly lower than[(1157.4±192.3)ng/mL,(16.3±2.0)ng/L,(115.9±20.5)pg/mL and(1.6±0.3)ng/mL,respectively,P<0.05]in the control group;the white blood cell counts,platelet counts and hemoglobin level in the observation were(5.4±1.1)×10^(9)/L,(101.3±17.3)×10^(9)/L and(120.8±19.5)g/L,all significantly higher than[(3.2±0.8)×10^(9)/L,(86.9±16.6)×10^(9)/L and(101.6±16.2)g/L,respectively,P<0.05]in the control.Conclusion The application of elbavir/glarevir in the treatment of CHC patients with genotype 1b infection is efficacious,with low untoward effects,which might be related to the low body response of inflammatory reactions.

关 键 词：慢性丙型肝炎 基因1b型 艾尔巴韦/格拉瑞韦 病毒学应答 治疗 

分 类 号：R512.63[医药卫生—内科学]