索非布韦联合达卡他韦对丙肝肝硬化与慢性丙肝疗效

Therapeutic Effect of Sofosbuvir Combined with Dacatavir on Hepatitis C Cirrhosis and Chronic Hepatitis C

目的研究索非布韦联合达卡他韦治疗丙肝肝硬化与慢性丙肝的疗效。方法选取2015年8月~2017年10月在我院门诊诊治的56例丙肝患者为研究对象,将21例丙肝肝硬化定义为观察组,35例慢性丙肝定义为对照组,两组均采用索非布韦联合达卡他韦治疗,比较两组病毒学应答率、治疗前后肝功能指标[天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、白蛋白(ALB)、总胆红素(TBIL)]、瞬时弹性成像值、肾脏功能指标[肌酐(CREA)、尿氮素(BUN)、尿酸(UA)]及临床不良反应发生情况。结果观察组病毒学应答率为66.67%,低于与对照组的100.00%,差异有统计学意义(P<0.05);治疗后两组AST、ALT、TBIL均低于治疗前,ALB高于治疗前,瞬时弹性成像值均低于治疗前,差异有统计学意义(P<0.05);两组肾功能指标CREA、BUN、UA与治疗前比较,差异无统计学意义(P>0.05);两组不良反应率比较,差异无统计学意义(P>0.05)。结论索非布韦联合达卡他韦治疗丙肝肝硬化与慢性丙肝均具有良好的疗效,但慢性丙肝的病毒学应答率较高。同时均可显著改善患者肝功能,促进肝损伤恢复,减轻肝纤维化程度的趋势,且对肾功能无明显影响,临床不良反应少,应用安全性良好。

Objective To study the curative effect of sofosbuvir combined with dacatavir in the treatment of hepatitis C cirrhosis and chronic hepatitis C.Methods 56 patients with hepatitis C who were treated in the outpatient department of our hospital from August 2015 to October 2017 were selected as the research object.21 cases of hepatitis C cirrhosis were defined as the observation group,and 35 cases of chronic hepatitis C were defined as the control group.sofosbuvir combined with dacatavir treatment,comparing the virological response rate,liver function indexes before and after treatment[aspartate aminotransferase(AST),alanine aminotransferase(ALT),albumin(ALB),Total bilirubin(TBIL)],instantaneous elastography values,renal function indicators[creatinine(CREA),urinary nitrogen(BUN),uric acid(UA)]and clinical adverse reactions.Results The virological response rate of the observation group was 66.67%,lower than that of the control group of 100.00%,the difference was statistically significant(P<0.05);after treatment,the AST,ALT,and TBIL in both groups were lower than before treatment,and ALB was higher than before treatment,the instantaneous elastography values were lower than before treatment,the difference was statistically significant(P<0.05);the renal function indexes CREA,BUN,UA of the two groups were not statistically significant compared with before treatment(P>0.05);the two groups compared with the adverse reaction rate,the difference was not statistically significant(P>0.05).Conclusion Sofosbuvir combined with dacataviris effective in treating hepatitis C cirrhosis and chronic hepatitis C,but the virological response rate of chronic hepatitis C is relatively high.At the same time,it can significantly improve the patient's liver function,promote the recovery of liver injury,reduce the trend of liver fibrosis,and have no obvious effect on renal function.There are few clinical adverse reactions and good application safety.