干扰素、辛伐他汀和利巴韦林联用对丙肝合并高脂血症患者血脂表达及炎性因子的影响

Effect of Interferon,Simvastatin Butyl and Ribavirin Combination Treatment on Serum Lipid Level and Inflammatory Factors in Patients with Hepatitis C Virus Co-infection with Hyperlipemia

目的探讨聚乙二醇干扰素α-2a(polyethylene glycol interferon alpha 2a,PEG-IFNα-2a)、辛伐他汀和利巴韦林联合用药对慢性丙型肝炎(chronic hepatitis C,CHC)合并高脂血症患者的血脂表达及炎性因子的影响。方法选择本院2016年1月至2016年12月诊治的240例慢性丙型肝炎合并高脂血症患者作为研究对象,随机分为单药治疗治疗组(PEG-IFNα-2a组、辛伐他汀组和利巴韦林组各60例)和联合用药治疗组(60例)四组,分析比较治疗48周后患者的血脂水平及炎性因子表达。结果治疗前,四组患者的血脂水平和炎性因子表达差异无统计学意义(P>0.05)。治疗后,四组患者的总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDLC)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、基质金属蛋白酶-9(matix metalloproteinase-9,MMP-9)、C反应蛋白(C reactive protein,CRP)和丙二醛(methane dicarboxylic aldehyde,MDA)表达水平与治疗前相比均有显著下降,而高密度脂蛋白胆固醇(high-density lipoproteincholesterol,HDL-C)则显著上升,差异具有统计学意义(P<0.05)。且联合用药组的各项指标水平显著优于单药治疗组(P<0.05)。结论 PEG-IFNα-2a、辛伐他汀和利巴韦林均能有效降低CHC合并高脂血症患者的血脂水平和炎性因子表达,且三者联合治疗的疗效更佳,值得在临床进一步推广。

Objective To explore the effects of PEG-IFN α-2a, simvastatin butyl and ribavirin combination treatment on serum lipid level and inflammatory factors in patients with CHC co-infection with hyperlipemia.Methods Total 240 patients with CHC co-infection with hyperlipemia from January 2016 to December 2017 were recruited in this study.The patients were randomized divided into monotherapy groups （PEG-IFN α-2a group 80 cases, simavastatin butyl group 80 cases and ribavirin 80 cases, respectively） and combination treatment group （80 cases）.The serum lipid level and inflammatory factors were compared after 48 weeks of treatment.Results Before treatment, the serum lipid level and inflammatory factors in four groups were similar（P〉0.05）.After 48 weeks of treatment, the levels of TC, TG, LDL-C, TNF-α, MMP-9, CRP, MDA were significantly lower than those before the therapy（P〈0.05）, while HDL-C was higher （P〈0.05）.The level of indexes in combination treatment group were higher than those in monotherapy groups（P〈0.05）.Conclusion PEG-IFN α-2a, simvastatin butyl and ribavirin would reduce the serum lipid level and inflammatory factors independently in patients with CHC co-infection with hyperlipemia, and the combination treatment is even more effective, it is worth to promote in clinical practices.