67例慢性丙型肝炎治疗过程及随访中血清ALT、病毒载量及肝纤维化指标的变化

67 cases of chronic hepatitis C treatment process and follow-up serum ALT, viral load and the change of liver fibrosis indexes

目的 观察聚乙二醇干扰素α-2b联合利巴韦林治疗慢性丙型肝炎过程中肝功能、病毒复制及肝纤维化指标的改变情况.方法 检测67例慢性丙型肝炎患者在干扰素联合利巴韦林治疗开始（0周）、结束（48周）和停药12周（60周）时血清丙氨酸转氨酶（ALT）、丙肝病毒核糖核酸（HCV RNA）、透明质酸（HA）、Ⅲ型前胶原肽（PCⅢ）、Ⅳ型胶原（Ⅳ-C）和层粘连蛋白（LN）水平.结果 治疗后完全应答组（CR-S,43/67） ALT、HCV RNA及血清4项纤维化指标均显著下降（P ＜0.05或P＜0.01）,部分应答组（CR-R,13/67）和无应答组（NR,11/67） ALT、HCV RNA及血清4项纤维化指标变化不明显,反跳甚至更高.结论 聚乙二醇干扰素α-2b联合利巴韦林治疗慢性丙型肝炎约65％患者完全应答,随着肝细胞炎症的改善,病毒RNA滴度、肝纤维化指标水平明显下降,表明干扰素联合利巴韦林能抑制HCV RNA复制,调节机体免疫功能,减轻肝脏炎症反应,改善肝功能,减少肝纤维化.

Objective Observation of polyethylene glycol （peg） interferon alpha 2 b plus ribavirin treatment of chronic hepatitis C liver function,viral replication and liver fibrosis index in the process of change.Methods Detection of 67 cases of chronic hepatitis C patients in the treatment with interferon plus ribavirin end of week （0）,（48 weeks） and drug withdrawal 12 weeks （60 weeks） in serum alanine aminotransferase （ALT）,hepatitis C virus （HCV） RNA （HCV RNA）,hyaluronic acid （HA）,a former Ⅲ type collagen peptide （PC Ⅲ）,collagen type Ⅳ （Ⅳ-C） and laminin （LN） level. Results Complete response after treatment group （CR-S,43/67） ALT,4 items of HCV RNA and serum fibrosis indexes were significantly decreased （P 〈 0.05 or P 〈 0.01）,part of the response group （CR-R,13/67） and no answer （NR,11/67） ALT,4 items of HCV RNA and serum fibrosis index change is not obvious,bounce is even higher.Conclusion Polyethylene glycol interferon alpha 2 b plus ribavirin treatment of chronic hepatitis C response,about 65% of patients completely as the improvement of liver inflammation,viral RNA drops and liver fibrosis index level declined obviously,suggest that interferon plus ribavirin can inhibit HCV RNA replication,regulate the body＇s immune function,reduce liver inflammation,improve liver function,reduce liver fibrosis.