聚乙二醇干扰素α-2a联合利巴韦林治疗老年慢性丙型肝炎的疗效与安全性评价

Efficacy and Safety of Peginterferon α-2a Combined with Ribavirin in Treatment of Elderly Patients with Chronic Hepatitis C

目的观察聚乙二醇干扰素α-2a（PEG-IFNα-2a）联合利巴韦林（RBV）治疗中青年慢性丙型肝炎（CHC）患者和老年CHC患者的疗效与安全性。方法选择2008年1月至2012年6月收治的73例成年CHC患者,分为中青年组18-50岁和老年组（60岁以上）。所有患者均给予PEG-IFNα-2a注射液180μg、每周1次,同时口服RBV片300-400 mg/次、3次/日,均用药48周。观察患者的病毒学应答、肝功能、免疫功能及不良反应发生情况。结果两组患者治疗48周后,持续病毒性应答率（SVR）、丙氨酸氨基转移酶（ALT）、天门冬酸氨基转移酶（AST）、CD3＋,CD4＋,CD8＋,CD4＋/CD8＋、自然杀伤细胞（NK）等比较均无统计学差异（P〉0.05）。但老年组患者在白细胞下降、抑郁或焦虑、腹胀、心电图异常等4项不良反应的发生率显著高于中青年组（P〈0.05）。结论 PEG-IFNα-2a和RBV联用治疗老年CHC有效,但必须重视不良反应。

Objective To compare the efficacy and safety of peginterferon α-2a（ PEG-IFN α-2a） combined with ribavirin（ RBV） in the treatment of young and middle-aged patients with chronic hepatitis C（ CHC） and elderly patients with CHC. Methods 73 adults inpatients with CHC in our hospital from January 2008 to June 2012 were selected as the research subjects and divided into the young and middle aged group（ 18- 50 years old） and the elderly group（ ≥ 60 years old） according to their age. All patients were given PEG-IFN α-2a injection 180μg, once per week and simultaneously took oral RBV tablets 300-400 mg, 3 times daily for 48 weeks. The virological response, liver function, immune function and adverse reactions were observed in the two groups. Results After 48-week treatment,there was no significant difference in sustained virological response（ SVR）,ALT,AST,CD3^＋,CD4^＋,CD8^＋,CD4^＋/ CD8^＋ and NK cell between the young and middle aged group and the elderly group（ P〉0. 05）. But the occurrence rates of some adverse reactions in the elderly group were higher than those in the young and middle aged group,including leukocytopenia,depression or anxiety,abdominal distension and electrocardiographic abnormality（ P〈0. 05）. Conclusion The combination use of PEG- IFN α- 2a and RBV is effective in the treatment of elderly CHC. However,the adverse reactions should be paid attention to.