聚乙二醇干扰素α-2a联合利巴韦林治疗慢性丙型肝炎合并2型糖尿病患者的临床分析

The clinical analysis of peginterferon aipha-2a with Ribavirin on chronic hepatitis C patients combined with type 2 diabetes mellitus

目的探讨慢性丙型肝炎（CHC）合并2型糖尿病（T2DM）患者使用聚乙二醇干扰素α-2a（Peg-IFNα-2a）联合利巴韦林（RBV）抗病毒治疗的效果和风险。方法对37例CHC合并T2DM患者（CHC＋T2DM组）和43例单纯丙肝病毒慢性感染者（CHC组）给予Peg—IFNα-2a联合RBV抗病毒治疗，对比分析两组的治疗效果。结果CHC＋T2DM组获得持续病毒学应答率低于CHC组（51．35％与88．10％，P〈0．05）；CHC＋T2DM组中3例患者因出现腹腔积液停止治疗，且出现白细胞减少、视网膜病变、甲状腺疾病、肺结节、皮肤瘙痒等不良反应发生率高于CHC组，但两组差异无统计学意义。两组患者抗病毒治疗中均未出现明显血糖异常。结论在积极监测、控制血糖基础上，对CHC合并T2DM患者进行合理的Peg—IFNα-2a联合RBV抗病毒治疗较为安全可行。

Objective To investigate the outcomes of peginterferon alpha-2a（PegIFN-α-2a） with ribavirin on chronic hepatitis C（CHC） patients combined with type 2 diabetes mellitus（T2DM）. Methods The study was a retrospective clinical trial to analyze the rates of virological response and adverse effects of 37 patients in CHC ＋ T2DM group compared with 43 CHC patients who received PegIFNα-2a combined with RBV respectively. Results Compared to CHC group, the CHC ＋ T2DM group showed significantly lower rates of sustained virological response（51.35% vs 88.10% ,P 〈 0. 05）. Among the CHC ＋ T2DM group, the treatment of three patients were stoped because of ascites. The incidence of leucopenia, retinopathy thyroid disorder, pulmonary nodule or pruritus in CHC ＋ T2DM group were higher than those in CHC group, but there were no significantly differences between two groups. And the level of blood glucose was not significantly fluetuant during anti-HCV therapy in two groups. Conclusion Use of an individualized PegIFNα-2a with RBV on CHC ＋ T2DM according to the monitoring and controlling of the patient＇ s blood glucose actively, antiviral treatment would be safe and entirely feasibile.