聚乙二醇干扰素联合利巴韦林治疗慢性丙型肝炎疗效观察及影响因素分析

The effect of polyethylene glycol,interferon combined with ribavirin in treatment of patients with chronic hepatitis C

目的:探讨聚乙二醇干扰素联合利巴韦林治疗慢性丙型肝炎的临床疗效及其影响因素。方法:收集慢性丙型肝炎患者142例,采用聚乙二醇干扰素联合利巴韦林作为抗病毒治疗方案,分别在治疗前、治疗第4周、第12周、第24周、第36周、第48周、治疗结束后24周检测HCVRNA载量。统计患者的持续病毒学应答率,同时对比不同临床资料患者的持续病毒学应答率以分析聚乙二醇干扰素联合利巴韦林治疗慢性丙型肝炎疗效的影响因素。结果:142例患者经过治疗后,快速病毒学应答率75.35%,治疗结束时病毒学应答率97.18%,持续病毒学应答率82.39%。对比不同临床资料患者的持续病毒学应答率,结果显示,年龄≤40岁、体质量<75kg、病程<10年患者的持续病毒学应答率显著高于年龄>40岁、体质量≥75kg、病程≥10年的患者(P<0.05);疗程越接近48周,聚乙二醇干扰素、利巴韦林累积用量越接近预计用量的患者,其持续病毒学应答率越高(P<0.05)。结论:聚乙二醇干扰素联合利巴韦林是慢性丙型肝炎较为理想的抗病毒方案,临床治疗中应尽量保证80%以上的疗程和80%以上的药物推荐剂量以获得更为理想的持续病毒学应答率。

Objective：To investigate the clinical effect and its influencing factors of polyethylene glycol,interferon combined with ribavirin in treatment of patients with chronic hepatitis C.Methods：142patients with chronic hepatitis C in our hospital were selected.The pegylated interferon combined with ribavirin as antiviral treatment,respectively,before treatment,fourth weeks,Twelfth weeks,twenty-fourth weeks,thirty-sixth weeks,24 weeks of testing HCV-RNA load,the end of the forty-eighth week after treatment.The sustained virologic response statistical rate of patients,at the same time,the sustained virologic response compared with patients with different clinical data rate in order to analyze the influence of PEG interferon combined with ribavirin effect in the treatment of chronic hepatitis C.Results：After treatment,rapid virological response rate was 75.35%,at the end of treatment virological response rate was 97.18%,the rate of sustained virological response was 82.39%.The sustained virologic response compared with patients with different clinical data rate,results show that,the sustained virologic response in patients 10 years of age≤40years old,body weight,duration of75kg was significantly higher than that of older than 40 years old,body mass ≥ 75 kg,≥ 10 years disease patients（P〈0.05）;the closer to 48 week course of treatment ribavirin,pegylated interferon,cumulative dosage of closer to the expected amount of patients,the sustained virologic response rate was higher（P0.05）.Conclusion：Pegylated interferon combined with ribavirin is antivirus solutions for chronic hepatitis C,should as far as possible to ensure that more than 80% of the courses and more than 80% of the drug dose recommendations for more sustained virologic response rate in the clinical treatment.