摘要
目的分析聚乙二醇干扰素(PEG-IFN)联合利巴韦林治疗慢性丙型肝炎(CHC)患者获得快速病毒学应答(RVR)的影响因素。方法 88例CHC患者采用PEG-IFNα-2a135-180μg或PEG-IFNα-2b50-80μg治疗,每周注射1次,联合利巴韦林900-1200mg/d治疗;基因1型疗程48周,非基因1型疗程24周。治疗前采用荧光定量PCR法检测HCV-RNA载量水平,并检测肝功能等指标,以病毒学应答评价疗效。结果 88例CHC患者获得RVR率为73.9%。治疗前获得RVR与未获得RVR患者间,年龄、ALT、RBC水平比较均无统计学差异(P>0.05),Plt和HCV-RNA差异有统计学意义(P<0.05)。65例获得RVR患者HCV-RNA<1×106copies/ml的比例高于HCV-RNA≥1×106copies/ml者(86.5%vs.64.7%)(P<0.05),且Plt≥100×109/L的比例高于Plt<100×109/L者(78.9%vs.41.7%)(P<0.01)。结论 PEG-IFN联合利巴韦林抗病毒治疗CHC患者中,血清低病毒载量及Plt高是获得RVR的主要影响因素。
Objective To analyze the factors influencing rapid virological response（RVR）achieved by the treatment of chronic hepatitis C（CHC）with combined use of pegylated interferon（PEG-IFN）and ribavirin.Methods A total of 88 patients with bCHC was treated with PEG-IFNα-2a135-180μg or PEG-IFNα-2b50-80μg once per week and ribavirin 900-1200mg/d.The patients with genotype 1were treated for 48 weeks and those with non-genotype 1were treated for 24 weeks.Before treatment,the level of hepatitis C virus（HCV）-RNA was measured by fluorogenic quantitative-PCR and liver function was detected as well.Virological response was taken as a main index for the evaluation of efficacy.Results The incidence rate of RVR was 73.9%in 88 patients with CHC.There were no significant differences in age,ALT,red blood cells between the patients with RVR and without RVR（P〉0.05）.There were significant differences in platelets and HCV-RNA level between the patients with RVR and without RVR（P〈0.05）.Among 65 patients with RVR,the proportion of patients with HCV-RNA level1×106copies/ml was higher than that of those with HCV-RNA level≥1×10^6copies/ml（86.5% vs.64.7%）（P〈0.05）,and the proportion of patients with Plt≥100×10^9/L was higher than that of those with Plt100×10^9/L（78.9%vs.41.7%）（P〈0.01）.Conclusion Lower level of HCV-RNA and higher Plt level are the main factors influencing RVR in anti-virus treatment of CHC with PEG-IFN and ribavirin.
出处
《江苏医药》
CAS
2015年第21期2559-2561,共3页
Jiangsu Medical Journal
