失代偿期丙型肝炎肝硬化患者抗病毒治疗临床研究

Clinical curative effect of antiviral therapy for patients with decompensated hepatitis C cirrhosis

目的对失代偿期丙型肝炎肝硬化患者并发症消除后进行抗病毒治疗,观察治疗效果。方法选取2009-2012年住院的失代偿期丙型肝炎肝硬化患者15例作为治疗组,进行手术消除并发症后进行抗病毒治疗,对照组15例同期失代偿期丙型肝炎肝硬化患者未进行抗病毒治疗,比较两组治疗效果及不良反应,采用SPSS15.0软件进行统计分析。结果治疗组所有患者经过手术消除并发症术后2周白细胞升高达到(6.7±1.93)×109/L,血小板计数显著升高达(104.8±30.26)×109/L,Child-Pugh评分(8±1)分,术后36周效果更显著,均达到抗病毒治疗的标准;采用PEG-IFNα-2a联合利巴韦林抗病毒治疗方案后,两组患者年均住院次数差异无统计学意义,治疗组Child-Pugh评分(6±1)分,低于对照组的(10±1)分,观察组ALT复常率、持续病毒学应答率,分别为93.3%、73.3%,高于对照组的46.6%、26.6%,差异有统计学意义(P<0.05);治疗组用药期间均出现流感症候群、白细胞下降、肠胃反应、失眠等不良反应,用药结束后消失,无死亡病例,对照组患者死亡1例。结论失代偿期丙肝肝硬化患者消除并发症后给予PEG-IFNα-2a联合利巴韦林治疗,能够有效的缓解肝硬化的进展,提高生活质量,延长生存时间。

OBJECTIVE To observe the therapeutic effect of antiviral therapy for the patients with decompensated hepatitis C cirrhosis after elimination of complications. METHODS Totally 15 patients with decompensated hepatitis C cirrhosis, who were hospitalized during 2009--2012, were chosen as the treatment group and treated with antiviral therapy after the elimination of complications, meanwhile 15 patients with decompensated hepatitis C cirrhosis, who did not receive the antiviral therapy, were set as the control group, then the therapeutic effect and the incidence of adverse events were observed and compared between the two groups, and the statistical analysis was performed with the use of SPSS15.0 software. RESULTS The complications were eliminated in all the patients of the treatment group, two week after surgery, the leukocyte counts reached up to （6.7--1.93） ）〈 109/L, the platelet counts significantly arrived at （104.8-t-30.26） X 10/L, and the Child Pugh score was（8_--＋- 1） points; the therapeutic effect was more significant 36 weeks after the surgery, all the indicators met the standards of antiviral therapy; after PEG-IFNa-2a combined with ribavirin anti-viral therapy, the difference in the average annum number of hospitalizations between the two groups was not statistically significant; the Child-Pugh score of the treatment group was（6 1） points, higher than （ 10 _--＋- 1） of the control group ; the ALT normalization rate of the observation group was 93.3, higher than 46.6 of the control group; the sustained virologic response rate of the observation group was 73. 3, higher than 26. 6 of the control group, the difference was statistically significant （P 0. 05） . In the treatment group, the adverse events such as flu syndrome, leukopenia, gastrointestinal reactions , and insomnia occurred during the medication and disappeared at the end of medication, and no case died; 1 case in the control group died. CONCLUSION The PEG-IFN-2a combined with ribavirin isgiven to the patients with decompensated hepatitis C cirrhosis after the elimination of complications, which can effectively alleviate the progress of liver cirrhosis, improve quality of life, and prolong survival time.