小剂量干扰素α-2b递增方案联合利巴韦林治疗失代偿期丙型肝炎肝硬化的疗效观察

Efficacy of low-dose interferon α-2b combined ribavirin on patient with hepatitis C-related decompensated cirrhosis with a low accelerating dose regimen

目的:观察应用干扰素α-2b小剂量开始逐渐加量,联合利巴韦林方案治疗失代偿期丙型肝炎肝硬化的临床疗效。方法:18例失代偿期丙型肝炎肝硬化患者采用干扰素α-2b(IFNα-2b)治疗。初始剂量为200万U/次,皮下注射,每周3次,加利巴韦林600mg/d,分3次口服,治疗1～3个月后,根据病情逐步将IFNα-2b剂量增加至300～500万U/次肌注及利巴韦林800～1000mg/d,分3次口服,治疗48周,观察疗效。结果:18例患者有17例耐受较好并完成IFN疗程,而1例无法耐受利巴韦林治疗提前终止。与治疗前比较,17例患者治疗后的ALT、AST、TBil、Alb、CHE、PTA、HCVRNA,肝纤维化指标(HA、LN、PCⅢ,C-Ⅳ)均有明显改善(P<0.05)。结论:小剂量IFNα-2b开始逐渐加量联合利巴韦林方案可治疗失代偿期丙型肝炎肝硬化患者,但治疗的远期疗效还有待进一步观察。

Objective：To observe the efficacy of low-dose interferon α-2b combined ribavirin on patients with hepatitis Crelate decompensated cirrhosis with a low accelerating dose rigemen.Methods：Eighteen patients with decompensated liver cirrhosis due to hepatitis C treated with interferon α-2b.The initial dose was 2 million U,three times a week,plus ribavirin 600mg/d,after the treatment 1～3 months,according to the disease gradually increased doses of interferon α-2b and ribavirin to 300～500 million U,800～1000mg/d,the treatment for 48 weeks to observe the effect.Results：Seventeen patients completed the interferon α-2b treatment among 18 patients.Compared with prior treatment,the loads of HCV RNA and the indexes of liver function （ALT,AST,TBil,Alb,CHE,PTA） and liver fibrosis markers （HA,LN,PCⅢ,C-Ⅳ） were significantly improved after treatment （P〈0.01）.Conclusion：The low accelerating-dose regimen of interferon α-2b plus ribavirin is an optional strategy for the treatment decompensated hepatitis C cirrhosis,but long-term efficacy of treatment remains to be seen.