慢性丙型肝炎抗病毒治疗后复发冷球蛋白血症的临床分析

目的探讨慢性丙型肝炎（CHC））合并血清冷球蛋白（MC）阳性患者抗病毒治疗后复发的临床特点。方法对冷球蛋白阳性组32例（阴性组49例作为对照）均应用聚乙二醇干扰素α-2a联合利巴韦林治疗，观察复发患者抗病毒应答状况与冷球蛋白的关系。结果冷球蛋白阳性组持续病毒学应答（SVR）低于阴性组（P〈0．05），复发率高于阴性组（P〈0．05）。获得完全快速病毒学应答（RVR）患者，复发率明显下降。冷球蛋白阳性组中复发患者治疗结束及治疗结束后24周冷球蛋白检出率均高于SVR组（P〈0．05）。结论慢性丙型肝炎合并冷球蛋白阳性的患者抗病毒应答率低于阴性患者，且易复发，但获得完全RVR患者，复发率明显下降。

Objective To investigate the clinical features of chronic hepatitis C （ CHC ） with serum cryoglobulin （ MC ） . Methods patients with positive recurrence after antiviral treatment of cryoglobulin positive group 32 cases （ 49 negative cases as control ） were pegylated interferon alpha -2a combined with Bavelyn therapy, to observe the relationship between recurrence in patients with antiviral response the status and cryoglobulins. Results （ 1 ） cryoglobulin positive group sustained virological response （ SVR ） was lower than that of negative group （ P〈0.05 ） , the recurrence rate is higher than the negative group （ P〈0.05 ） . （ 2 ） obtained the rapid virological response completely （ RVR ） patients, the recurrence rate was significantly decreased. （ 3 ） cryoglobulin positive in the group of recurrent patients after treatment and 24 weeks after the end of treatment Lengqiu protein detection rate were higher than that of group SVR （ P〈0.05 ） in patients with antiviral response cryoglobulin positive rate is lower than the negative group. Conclusion For chronic hepatitis C with serum cryoglobulin, the viral response is lower, and it is easier to relapse, but for completely RVR patients, the recurrence rate decreases significantly.