丙型病毒性肝炎46例采用普通干扰素治疗效价比分析

Analysis of potency ratio for 46 hepatitis C case with ordinary interferon treatment

目的探讨低收入慢性丙型病毒性肝炎患者可接受的治疗方案。方法选择慢性丙型病毒性肝炎患者92例,其中男性50例,女性42例;年龄18~61岁,平均年龄38.3岁。随机分普通干扰素组和长效干扰素组,各46例。两组临床资料、治疗过程、变异情况、快速病毒学应答（RVR）、早期病毒学应答（EVR）、延迟应答（DVR）、持续病毒学应答（SVR）等相似。两组治疗采用联合利巴韦林方案,普通干扰素组采用重组人干扰素α-2b（安福隆）治疗,长效干扰素组采用选用标准治疗方案（派罗欣）治疗。比较两组安全性、有效性、治疗费用等指标。结果两组的疗效及安全性差异无统计学意义（χ2=0.5,P=0.47〉0.05）。普通干扰素组,非1 b型1个疗程费用7 875元;1 b型1个疗程费用14 625元。长效干扰素组,非1 b型1个疗程费用28 800元;1 b型1个疗程费用57 600元。两组比较,差异有显著统计学意义（P〈0.001）。结论在目前严格＂医改、新农合＂等政策背景下,农村低收入患者抗慢性丙型病毒性肝炎病毒治疗的最佳方案是首选普通干扰素。

Objective To evaluate the acceptable treatment regimens of low-income people with chronic hepatitis Cvirus infection. Methods A total of 92 cases with chronic hepatitis Cvirus infection were enrolled, which included 50 males and 42 females, aged 18- 61 years old with mean age of 38.3 years old. All of them were divided into 2 groups randomly, included ordinary interferon group（n = 46） and long-acting interferon group（n = 46）. The clinical data, treatment process, variation, rapid virological response（RVR）, early virological response（ECR）, delayed virological response（DVR） and sustained virological response（SVR） in 2groups were similar. The combinations with Ribaririn scheme were performed in 2 groups. The ordinary interferon group was treated by recombinant human interferon α-2b and long-acting interferon group was treated by standard of care（SOC）. The safety, efficacy and cost of treatment were compared between 2 groups. Results The efficacy and safety in 2 groups were no significant differences（χ2= 0.5,P = 0.47 〉 0.05）. The cost of one treatment course for non-1b was 7 875 yuan and 1b was 14 625 yuan in ordinary interferon group. The cost of one treatment course for non-1b was 28 800 yuan and 1b was 57 600 yuan in long-acting interferon group. There was significantly difference between 2 groups（P 〉 0.001）. Conclusion It is demonstrated that in policy background of strict medical reform and new rural cooperative, the best scheme is ordinary interferon for low-income patients with chronic hepatitis C in rural areas.