聚乙二醇干扰素α-2b联合利巴韦林个体化治疗代偿期丙肝肝硬化

To Investigate the Efficacy and Safety of Pegylated-interferonα-2b Plus Ribavirin in Treatment of Patients with Hepatitis C Compensated Cirrhosis

目的探讨个体化剂量聚乙二醇干扰素α-2b（佩乐能）联合利巴韦林抗病毒治疗代偿期丙型肝炎肝硬化患者的有效性、安全性及耐受性。方法选择2013年5月-2015年4月珠海市人民医院门诊及住院的20例符合抗病毒条件的丙型肝炎肝硬化代偿期患者,应用个体化剂量（每周50-100μg）聚乙二醇干扰素α-2b联合利巴韦林（每日800-1 200 mg）进行24-72周治疗,检测治疗过程中丙型肝炎病毒核酸定量（HCV-RNA）等指标,回顾性选择同期未进行抗病毒治疗的代偿期丙肝肝硬化患者10例为对照组。结果治疗组治疗中达到快速病毒学应答（RVR）者50.0%（10/20）,进一步治疗达到早期病毒学应答（EVR）者80.0%（16/20）,治疗结束后达到持续病毒学应答（SVR）者70.0%（14/20）,无应答（NR）者10.0%（2/20）治疗疗程均少于4周,复发（RR）者10.0%（2/20）HCV亚型均为1 b型;对照组无HCV-RNA转阴（0%）,其中40%（4/10）进展至失代偿期肝硬化,20%（2/10）合并原发性肝癌。结论佩乐能联合利巴韦林个体化抗病毒治疗对代偿期丙肝肝硬化有确切疗效,可使大部分患者实现持续性病毒学应答,控制和缓解病情。在现阶段,也使部分需要直接抗病毒药物（DAAs类）治疗的患者通过本方案治疗控制肝硬化向失代偿期发展,以等待药物在我国上市后使用,起到积极的治疗作用。

OBJECTIVE To investigate the effectiveness, safety and drug tolerance of pegylated-interferouα-2b （PegIFNα-2b） plus ribavirin on hepatitis C compensated cirrhosis patients. METHODS Clinical data of 20 hepatitis C compensated cirrhosis patients were collected from Zhuhai Municipal People＇ s Hospital during May 2013 and April 2015, andl0 patients did not receive antiviral treatment as control. The patients of treatment group received 24-72 weeks of PegIFNα-2b plus ribavirin, the dosage of PegIFNα-2b and ribavirin may vary gradually according to the side effects and tolerance. Clinical efficacy and adverse evemts of the two groups were evaluated. RESULTS RVR,EVR,SVR and NR in the treatment group were 50.0% （10/20） ,80.0% （16/20） ,70.0% （14/20） ,and 10.0% （2/20） respectively,20.0% （4/20） of RR were HCV genetypelb. In the control group,HCV-RNA turn negative was 0%, 40.0%（4/10） of patients development to lose decompensate cirrhosis,and 20.0% （2/10） complicated with HCC. CONCLUSION For the hepatitis C compensated cirrhosis patients, pegIFNα-2b plus ribavirin individual antiviral therapy has exact effect.