聚乙二醇干扰素与普通干扰素治疗慢性丙型肝炎的临床观察

Comparisin of the efficacy on pegylated interferon and interferon in the treatment of chronic hepatitis C

目的探讨聚乙二醇干扰素(pegylated interferon,PEG-IFN)与普通干扰素(standard interferon,IFN)治疗慢性丙型肝炎的疗效和骨髓抑制情况。方法将61例接受PEG-IFN或IFN治疗的慢性丙型肝炎患者为研究对象,回顾性分析两组ALT复常、HCV-RNA阴转及骨髓抑制情况。结果慢性丙肝患者治疗4、12、24、48周,PEG-IFN组HCV-RNA水平显著低于IFN组;IFN组治疗12周、24周、48周及治疗后12周、24周HCV-RNA阴转率分别为34.48%、44.83%、55.17%、48.28%、37.93%,ALT复常率分别为55.17%、62.07%、65.52%、68.97%、65.52%;而PEG-IFN组HCV-RNA阴转率分别为50%、59.38%、71.88%、68.75%、62.5%,ALT复常率分别为65.63%、78.13%、84.38%、84.38%、81.25%。PEG-IFN组在ALT复常、HCV-RNA阴转率等方面疗效均明显高于IFN组。在24、48周时,PEG-IFN组WBC、Neu下降程度较IFN组明显,Plt只在24周差异较明显。按年龄分成3组后,PEG-IFN组的ALT复常率及HCV-RNA阴转率均显著高于IFN组。结论 PEG-IFN治疗慢性丙肝,在ALT复常率及HCV-RNA阴转率方面优于IFN,但骨髓抑制较明显。

Objective To compare of the efficacy on pegylated interferon and interferon at different time points in the treatment of chronic hepatitis C and differences in the extent of inhibition of bone marrow. Methods A case-control study was performed on 61 patients with chronic hepatitis C who received PEG-IFN or IFN treatment.Among the patients,Analysis were performed to evaluate the recovery rate of ALT,the negative rate of HCV-RNA and bone marrow suppression in PEG-IFN group and IFN group. Results HCV-RNA level of patients who received PEG-IFN treatment was lower than that in patients who received IFN treatment in 4,12,24,48 weeks. The negative rate of HCV-RNA in IFN group were 34.48%,44.83%,55.17%,48.28%,37.93%,respectively in 12 weeks,24 weeks,48 weeks and 12,24 weeks after treatment. The recovery rate of ALT were 55.17%,62.07%,65.52%, 68.97%,65.52%,respectively;The negative rate of HCV-RNA in PEG-IFN group were 50%,59.38%,71.88%,68.75%,62.5% respectively;the recovery rate of ALT were 65.63%,78.13%,84.38%,84.38%,81.25% respectively;In PEG-IFN group,the recovery rate of ALT and the negative rate of HCV-RNA was significantly higher than those in IFN group. And in the24,48 weeks,White blood cells and Neutrophile granulocyte in PEG-IFN group decreased obviously compared with those in IFN group,platelet in only 24 weeks more obvious differences. In all of 3 different age groups,ALT recovery rate and the negative rate of HCV-RNA in PEG-IFN group were significantly higher than those in IFN group. Conclusion In the treatment of chronic hepatitis C,the recovery rate of ALT and the negative rate of HCV-RNA in PEG-IFN group was better than those in IFN group,but the bone marrow suppression was obvious.