摘要
目的总结1例肾移植术后丙型病毒性肝炎患者的循证治疗方案。方法在充分评估患者病情的基础上,根据PICO原则,提出临床问题并转换成便于检索的形式,检索Cochrane图书馆(2009年第1期)、PubMed(1995～2009.3)和中国期刊全文数据库(CHKD,1995～2008.12)。结果共检索出治疗肾移植术后丙型肝炎抗病毒治疗的英文文献17篇,其中Meta分析1篇;中文文献1篇。目前肾移植术后丙型肝炎抗病毒治疗的措施有单用利巴韦林,单用干扰素及干扰素联合利巴韦林,以干扰素联合利巴韦林的效果最好。根据检索结果,结合患者意愿,笔者为患者制定了聚乙二醇干扰素α-2b50μg/周联合利巴韦林600mg/天治疗6个月的方案。从治疗两个月后始,患者HCVRNA阴转,肝肾功能持续正常,未出现不良反应,患者对治疗效果满意。现已治疗6个月,仍在随访观察中。结论聚乙二醇干扰素联合利巴韦林可用于肾移植术后丙型肝炎的抗病毒治疗,并能维持移植肾的功能。
Objective To formulate an evidence-based treatment plan for a patient with hepatitis C after kidney transplantation with combination of interferon-α and ribavirin. Methods Based on an adequate assessment of the patient＇s condition and using the principle of PICO, we searched The Cochrane Library （Issue 1, 2009）, PubMed （1995 to March 2009）, and CHKD （1995 to 2008.12）. Results Eighteen studies were identified including 17 in English （5 case reports, 11 cohort studies, and 1 meta-analysis） and 1 in Chinese. According to the current evidence as well as the patient＇s clinical condition and preference, PEG-IFNα-2b 50 μg/week plus ribavirin 600 mg/day was given to the patient for 6 months. Conclusion Evidence-based approaches help us to prepare the anti-viral therapy plan and will improve the assessment of the efficacy and safety in kidney transplantation.
出处
《中国循证医学杂志》
CSCD
2009年第11期1238-1240,共3页
Chinese Journal of Evidence-based Medicine
关键词
肾移植
丙型肝炎
干扰素
利巴韦林
循证治疗
Kidney transplantation
Hepatitis C
Interferon α
Ribavirin
Evidence-based treatment
