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研究

Study on the influencing factors of interferon/ribavirin in patients with chronic hepatitis C

目的分析聚乙二醇干扰素联合利巴韦林(pegylated interferon plus ribavirin,peg IFN-α/RVB)治疗慢性丙型肝炎(chronic hepatitis C,CHC)疗效的影响因素,以便辅助判断治疗效果及合理变换治疗方案。方法收集来自江苏省句容市人民医院CHC临床治疗患者的基线资料,采用单因素及多因素Logistic回归进行分析。结果本研究纳入371例CHC患者,总持续性病毒学应答(sustained virological response,SVR)率为64.7%。多因素Logistic回归分析结果显示,基线病毒载量HCV RNA高(OR=0.95,95%CI:0.91~0.99,P=0.012)、甲胎蛋白(alpha fetoprotein,AFP)水平异常(OR=0.87,95%CI:0.78~0.97,P=0.014)及空腹血糖(blood glucose,GLU)水平异常(OR=0.86,95%CI:0.78~0.95,P=0.004)者更不易获得SVR。结论 peg IFN-α/RVB治疗CHC患者的SVR率较高,基线病毒载量、AFP及GLU均是影响持续病毒学应答的危险因素。

Objective To analyze the baseline influencing factors of pegylated interferon plus ribavirin（ peg IFN-α/RVB） in the treatment of chronic hepatitis C（ CHC） in order to help to judge the therapeutic effect and the reasonable treatment plan. Methods The baseline data of CHC patients in Jurong People＇s Hospital of Jiangsu Province were collected and analyzed by univariate and multivariate Logistic regression. Results A total of 371 patients with hepatitis C was surveyed. The total SVR rate was 64. 7%. Multivariate logistic regression analysis showed that high baseline viral load of HCV RNA（ OR = 0. 95,95% CI： 0. 91-0. 99,P = 0. 012）,abnormal alpha fetoprotein（ AFP） level（ OR = 0. 87,95% CI：0. 78-0. 97,P = 0. 014） and abnormal fasting blood glucose（ GLU） level（ OR = 0. 86,95% CI： 0. 78-0. 95,P = 0. 004）were less likely to get SVR. Conclusions The SVR rate was higher in the treatment of peg IFN-α/RVB with CHC patients. Baseline viral load,AFP and GLU are the factors affecting the sustained virological response after treatment.