索磷布韦维帕他韦对丙型病毒性肝炎肝硬化的抗病毒效果及肝纤维化的影响

The antiviral effect of sofosbuvir and vipatavir on hepatitis C liver cirrhosis and its influence on liver fibrosis

目的分析索磷布韦维帕他韦对丙型病毒性肝炎肝硬化的抗病毒效果及肝纤维化的影响。方法60例丙型病毒性肝炎肝硬化患者,采用数字表随机分为对照组及观察组,每组30例。对照组给予聚乙二醇干扰素α-2a联合利巴韦林治疗,观察组给予索磷布韦维帕他韦治疗。比较两组患者治疗前后的肝功能指标[凝血酶原活动度(PTA)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)]和肝纤维化指标[Ⅳ型胶原(CⅣ)、层粘连蛋白(LN)、Ⅲ型前胶原氨基端肽(PⅢNP)、透明质酸(HA)]、疗效、不良反应发生情况。结果治疗后,两组患者PTA、AST、TBIL、ALT和CⅣ、LN、PⅢNP、HA水平均较本组治疗前改善,且观察组改善程度优于对照组,差异具有统计学意义(P<0.05)。观察组患者治疗总有效率93.33%高于对照组的73.33%,差异具有统计学意义(χ^(2)=4.320,P<0.05)。两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论索磷布韦维帕他韦对丙型病毒性肝炎肝硬化的治疗效果确切,可有效改善患者的病情和肝功能,有效抗肝纤维化,无严重不良反应,安全性高,值得推广和应用。

Objective To analyze the antiviral effect of sofosbuvir and vipatavir on hepatitis C liver cirrhosis and its influence on liver fibrosis.Methods A total of 60 patients with hepatitis C liver cirrhosis were divided into control group and observation group according to random numerical table,with 30 cases in each group.The control group was treated with pegylated interferonα-2a,and the observation group was treated with sofosbuvir and vipatavir.The liver function indexes[prothrombin activity(PTA),aspartate aminotransferase(AST),total bilirubin(TBIL),alanine aminotransferase(ALT)]and liver fibrosis indicators[typeⅣcollagen(CⅣ),laminin(LN),precollagen typeⅢN-terminal peptide(PⅢNP),hyaluronic acid(HA)]before and after treatment,efficacy,and occurrence of adverse reactions were compared between the two groups.Results After treatment,the levels of PTA,AST,TBIL,ALT,CⅣ,LN,PⅢNP and HA of the two groups were better than those before treatment,and the observation group was better than the control group.The difference was statistically significant(P<0.05).The total effective rate 93.33%of the observation group was higher than 73.33%of the control group,and the difference was statistically significant(χ^(2)=4.320,P<0.05).There was no statistically significant difference in incidence of adverse reactions between the two groups(P>0.05).Conclusion Sofosbuvir and vipatavir shows affirmative effect on hepatitis C liver cirrhosis,which can effectively improve the patient’s condition and liver function,effectively resist liver fibrosis with no serious adverse reactions and high safety,and is worthy of promotion and application.