对贵刊刊登《利巴韦林滴鼻治疗感冒优于静脉滴注》一文的验证

门诊就诊感冒病人 5 8例 ,给利巴韦林注射液滴鼻 ,q 3h滴 1次 ,每侧鼻孔滴 4～ 6滴。用药 1,2 ,3d后 ,治愈病例分别为 18例 (31% ) ,2 9例(5 0 % ) ,11例 (19% ) ,未见不良反应     

An emerging role for interferon in haemophiliacs with chronic hepatitis C?

The combination of interferon (IFN) and ribavirin is the current gold standard for treatment of chronic hepatitis C virus (HCV) infection with sustained remission rates of 35--40% being achieved in haemophilic patients. A similar beneficial effect of this combined therapy has been suggested even for patients with compensated liver cirrhosis and some authors have reported a possible role for IFN and ribavirin in the prevention or delay in the development of hepatocellular carcinoma (HCC), a well known complication of HCV infection in haemophiliacs. The absence, due to design difficulties, of definite randomized controlled clinical trials remains a handicap for the routine use of specific therapy of HCV infected patients with the aim of preventing HCC. A discussion of these important issues has been performed in this paper.     

三氮唑核苷治疗低血压休克期的流行性出血热23例

本组采用三氮唑核苷(病毒唑ribavirin)治疗流行性出血热低血压休克期的患者23例(男17例,女6例;年龄20-65yr,平均44±15yr),每日1g,疗程5d。结果:治疗组退热及血压稳定时间、少尿及多尿持续时间、尿蛋白消退及尿素氮(BUN)恢复正常时间均较对照组短(P<0.05),且未见明显副作用。     

病毒唑与胸腺素联用治疗流行性出血热

用病毒唑与胸腺素联合治疗33例流行性出血热(治疗组),并以不用上述两药而其它治疗基本相似的30例患者为对照组。结果治疗组主要临床症状改善情况优于对照组,治疗组越期率(57.57％)和治愈率(100％)均高于对照组(30％和90％),治疗组无死亡,对照组病死率为10％。本结果提示病毒唑与胸腺素联合治疗流行性出血热效果较好。     

干扰素治疗乙脑53例疗效分析

目的　了解干扰素治疗早期乙脑的效果。方法　对 5 3例乙脑患者随机分治疗组和对照组。观察病人用药后体温复常时间、意识障碍好转时间、极期持续时间及预后。结果　治疗组体温复常时间、意识障碍好转时间及极期持续时间均短于对照组 ,两组间有显著差异 (P <0 .0 5 )。结论　干扰素能抑制乙脑病毒复制 ,调节机体免疫功能 ,从而使乙脑患者病情改善快 ,治愈率高。     

A liver slice culture-based ex vivo assay to predict the outcome of antiviral therapy for chronic hepatitis C

Summary.  A liver slice culture-based, ex vivo drug suppression assay was developed as a pre-therapeutic predictor for the outcome of antiviral therapy. To investigate its clinical application, 106 consecutive patients with chronic hepatitis C virus (HCV) infection were evaluated. Ex vivo drug suppression assay was performed before administrating a standard course of peginterferon plus ribavirin combination therapy. Stepwise logistic regression model was used to estimate sustained virological response (SVR) on the presence of various clinicopathological parameters. Suppression of HCV replication in the ex vivo assay was present in 32 patients, 29 (90.6%) of whom achieved SVR. Stepwise logistic regression analysis indicated that the presence of interferon suppression effect in the ex vivo assay (odds ratio [OR], 5.552; 95% confidence interval [CI], 1.114–27.673; P  = 0.036), genotype 1 (OR; 0.045, 95% CI, 0.008–0.259; P  = 0.001), HCV-RNA level (OR, 0.739; 95% CI, 0.617–0.885; P  = 0.001), the presence of fatty metamorphosis (OR, 0.205; 95% CI, 0.053–0.793; P  = 0.022), and albumin (OR, 9.687; 95% CI, 2.237–41.940; P  = 0.002) were independent determinants of SVR. Categorical analysis revealed that 17 of 17 (100%) patients with genotype non-1 and positive ex vivo suppression test achieved SVR, while 20 of 40 (50%) with genotype 1 and negative ex vivo suppression test achieved SVR. In conclusion, the ex vivo drug suppression assay may serve as an independent pre-therapeutic predictor for the SVR in interferon-based antiviral therapy.     

The combination of type I interferon and ribavirin has an inhibitory effect on mouse hepatitis virus infection

Aim: To determine the differences in efficacy between therapy using IFN‐β and ribavirin, and using IFN‐α and ribavirin. Methods: We studied the effect of combination therapy consisting of IFN‐β and ribavirin on mouse hepatitis virus (MHV) infection in mice. Results: Combination treatment of ribavirin and IFN‐α was more effective than IFN‐α mono‐treatment in the MHV‐mouse system, and combination treatment with ribavirin and IFN‐β was more effective than IFN‐β mono‐treatment in the MHV‐mouse system. Furthermore, administering IFN‐β once or twice one day before combination treatment using ribavirin and IFN‐α was more effective than administering IFN‐α once or twice one day before the combination treatment using ribavirin and IFN‐α. Conclusion: These data indicate that this MHV‐infection system is a good animal model to assess anti‐HCV activity for therapy using IFN and ribavirin, and suggest that administering IFN‐β before the start of combination therapy with ribavirin and IFN‐α promotes the therapeutic effects of combination treatment with ribavirin and IFN‐α ?in chronic hepatitis C patients.     

聚乙二醇干扰素加利巴韦林治疗慢性丙型肝炎疗效影响因素分析

目的研究聚乙二醇干扰素α-2a联合利巴韦林治疗慢性丙型肝炎（丙肝）疗效的影响因素。方法101例慢性丙肝患者均给予聚乙二醇干扰素α-2a 180μg／周联合利巴韦林10．6～15．0mg／（kg·d）,疗程48周,分析性别、体重指数（body mass index,BMI）、初始HCVRNA定量、ALT及GLU等对持续病毒学应答（sustainedvirologicresponse,SVR）的影响。结果聚乙二醇干扰素α-2a联合利巴韦林治疗慢性丙肝总的SVR率为50％,其中获得快速病毒学应答（rapid virologic response．RVR）和早期病毒学应答（early virologic response,EVR）患者实现SVR达100％,未获得RVR和EVR患者实现SVR为19．35％;高BMI值、发生脂肪肝的患者不容易达到SVR,而糖化血红蛋白、初始HCVRNA载量高、GLU、ALT及性别对SVR无影响。结论RVR、EVR可以预测SVR;BMI、是否合并脂肪肝是聚乙二醇干扰素α-2a联合利巴韦林治疗慢性丙肝获得SVR的影响因素。     

Successful antiviral therapy determines a significant decrease in squamous cell carcinoma antigen‐associated (SCCA) variants’ serum levels in anti‐HCV positive cirrhotic patients*

Summary. Aberrant squamous cell carcinoma antigen (SCCA) expression is an early event in hepatocarcinogenesis, and increasing serum levels of SCCA variants IgM immune complexes (SCCA‐IgM IC) have been found in cirrhotic patients developing hepatocellular carcinoma (HCC). We longitudinally evaluated a cohort of cirrhotic patients with hepatitis C virus infection (HCV) who underwent pegylated interferon (PEG‐IFN) and ribavirin treatment. SCCA‐IgM IC levels were assessed in the sera of 33 cirrhotic patients with HCV (21 males, median age 57 years) before, at the end and at 6‐month and 1‐year follow‐up after treatment with PEG‐IFN and ribavirin. SCCA‐IgM IC serum levels (arbitrary units/mL, AU/mL) were evaluated according to treatment outcome: sustained virological response (SVR) vs nonresponse (NR). Overall, 15 patients obtained a SVR to antiviral therapy (45%). There was no significant difference in baseline SCCA‐IgM IC serum levels between SVR and NR patients. When compared to baseline (451.2 AU/mL), SVR patients showed a significant decrease in median SCCA‐IgM IC serum levels at the end of treatment (186.8 AU/mL, P = 0.013) and at both 6‐month (96.8 AU/mL, P < 0.001) and 1‐year follow‐up (52.4 AU/mL, P < 0.001), while no significant modification was observed in NR patients. In patients with HCV‐related liver cirrhosis, successful antiviral therapy is associated with a dramatic and significant decrease in SCCA‐IC serum levels. Because of the pathophysiological correlation between SCCA and liver carcinogenesis, it is hypothesized that in patients with liver cirrhosis, SVR may be accompanied by a decreased proliferative stimulation.