干扰素α-2b联合利巴韦林治疗慢性丙型肝炎患者疗效观察

A clinical observation of interferon alfa-2b plus ribavirin in treatment of patients with chronic hepatitis C

目的观察普通干扰素联合利巴韦林治疗慢性丙型肝炎患者的临床疗效。方法 87例慢性丙型肝炎患者被随机分成对照组44例和观察组43例,均应用重组人干扰素α-2b联合利巴韦林治疗,分别治疗48周和72周,随访24周,观察疗效。结果在44例对照组患者中,HCV 1b型感染者28例(63.6%),2a型感染者8例(18.2%),在观察组43例患者中则分别为29例(67.4%)和6例(14.0%);对照组获得快速病毒学应答率(RVR)、早期病毒学应答(EVR)、治疗结束时应答(ETR)和持续病毒学应答率(SVR)分别为40.9%、59.1%、68.2%和38.6%,而观察组则分别为39.5%、60.5%、88.4%(P<0.05)和65.1%(P<0.05);根据血清HCV RNA水平是否≥1×106copies/m1,将两组患者分为高病毒载量组和低病毒载量组,结果两组低病毒载量组患者的ETR和SVR均显著高于高病毒载量组(P<0.05)。结论延长干扰素联合利巴韦林治疗慢性丙型肝炎的疗程有助于提高SVR。

Objective To observe the clinical efficacy of interferon alfa-2b and ribavirin in the treatment of patients with chronic hepatitis C. Methods 87 patients with chronic hepatitis C were randomly divided into two groups,and the patients in both groups were treated with interferon alfa-2b and ribavirin. The regimen lasted for 48 weeks in 44 patients in control and for 72 weeks in 43 patients in the observation group. All the patients were followed-up for 24 weeks after discontinuation of the treatment. Results The HCV genotype 1b and 2a infections were found in 28（63.6%）and 8 patients（18.2%）in the control group,while they were in 29（67.4%）and 6 patients（14.0%）in the observation groups;The rapid virologic response（RVR）,early virologic response（EVR）, virologic response at the end of treatment（ETR）and sustained virologic response（SVR）in control group were 40.9%, 59.1%,68.2% and 38.6%,respectively,while they were 39.5%,60.5%,88.4%（P＆lt;0.05）and 65.1%（P＆lt;0.05）,respec-tively in the observation group;We divided the patients in both groups into with high and low serum virologic loads as their serum HCV RNA≥1×106copies/m1,the ETR and SVR in patients with low serum virologic load in both groups were higher than those in patients with high serum viral loads （P〈0.05）. Conclusion Prolonged course of interferon-α and ribavirin treatment in patients with chronic hepatitis C might improve the efficacy and get higher SVR.