热毒宁联合利巴韦林治疗手足口病疗效分析

目的分析热毒宁联合利巴韦林治疗手足口病的疗效。方法选取2011年10月—2012年6月该院收治的1168例手足口病患者,随机分为观察组（584例）和对照组（584例）,观察组应用热毒宁联合利巴韦林治疗,对照组仅应用利巴韦林治疗,比较治疗后效果。结果观察组在临床症状及体征方面明显优于对照组,差异有统计学意义（P〈0.05）。结论热毒宁联合利巴韦林治疗手足口病的疗效好,值得临床推广使用。     

利巴韦林注射液在细胞水平上抑制EV71病毒复制的初步研究

目的 通过体外实验,观察利巴韦林注射液对肠道病毒71型(EV71)病毒在横纹肌肉瘤传代细胞(RD-A细胞)复制的抑制作用和体外灭活作用.方法 使用在2008年4月安徽阜阳疫情中分离到的EV71病毒,通过三种体外细胞实验:药物在细胞中抑制EV71病毒复制的药效测定实验;药物对细胞的保护作用实验;药物体外对EV71病毒的灭活作用的药效测定实验.观察利巴韦林注射液对EV71病毒感染横纹肌肉瘤传代细胞(RD-A细胞)中所起的作用.结果 在利巴韦林注射液在细胞中抑制EV71病毒复制的药效测定实验中,1:640利巴韦林注射液稀释度组较病毒对照组延迟病变出现2 d,细胞生长未受到影响.在药物对细胞的保护作用实验中,1:8利巴韦林稀释度组较病毒对照组延迟病变出现4 d.在利巴韦林注射液药物体外对EV71病毒的灭活作用的药效测定研究中,1:40稀释度组较病毒对照组延迟病变出现2 d,而细胞生长未受到影响.结论 利巴韦林注射液在体外有抑制EV71病毒复制和部分灭活病毒的作用;并有一定的保护细胞抑制EV71病毒感染的作用.本研究对于临床上EV71感染的早期预防和治疗具有一定的指导意义.     

肾上腺素联合病毒唑雾化治疗小儿毛细支气管炎的临床研究

目的：探讨肾上腺素联合病毒唑雾化治疗小儿毛细支气管炎的临床疗效。方法：80例小儿毛细支气管炎随机分为联合治疗组和对照组,两组患儿均应用综合治疗,联合治疗组在综合治疗的基础上加用空气加压泵吸入病毒唑、肾上腺素治疗。对治疗后症状、体征改善时间及疗效进行比较。结果：联合治疗组疗效优于对照组,总有效率分别为87.5%与70%,联合治疗组各项指标均好于对照组。结论：病毒唑、肾上腺素雾化吸入能加快毛细支气管炎的治愈过程,起效快,疗效满意。     

Sudden hearing loss associated with peginterferon and ribavirin combination therapy during hepatitis C treatment

Adverse effects associated with peginterferon and ribavirin during hepatitis C treatment are well known. Sudden hearing loss has rarely been reported. Possible mechanisms involved include direct ototoxicity of interferon, autoimmunity, and hematological changes. Hearing loss is frequently fully resolved after discontinuation of antiviral therapy. We report a 47-year- old man with chronic hepatitis C, genotype 2 ac who developed sudden hearing loss 22 wk after starting therapy with peginterferon alpha 2a at a dose of 180 ~g per week and ribavirin 800 mg per day. Since symptoms did not worsen, antiviral therapy was continued for 2 wk, according to the patient＇s wish. Hearing loss resolved within 2 wk after the end of treatment. Serum liver alanine aminotransferase remained normal during and after the end of antiviral therapy. HCV RNA was undetectable at the end of therapy and remained negative 24 wk later. Thus, patients should be aware that hearing loss may occur with peginterferon therapy, but the decision whether to continue or to stop the treatment is based on the clinical judgment of the physician and the wishes of the patient.     

An extremely rare case of delusional parasitosis in a chronic hepatitis C patient during pegylated interferon alpha-2b and ribavirin treatment

During treatment of chronic hepatitis C patients with interferon and ribavirin, a lot of side effects are described. Twenty-three percent to 44% of patients develop depression. A minority of patients evolve to psychosis. To the best of our knowledge, no cases of psychogenic parasitosis occurring during interferon therapy have been described in the literature. We present a 49-year-old woman who developed a delusional parasitosis during treatment with pegylated interferon alpha-2b weekly and ribavirin. She complained of seeing parasites and the larvae of fleas in her stools. This could not be confirmed by any technical examination. All the complaints disappeared after stopping pegylated interferon alpha-2b and reappeared after restarting it. She had a complete sustained viral response.     

Fulminant hepatic failure in a case of autoimmune hepatitis in hepatitis C during peg-interferon-alpha 2b plus ribavirin treatment

A 27-year-old Caucasian female with hepatitis C virus (HCV) infection treated with interferon (IFN) who developed severe autoimmune hepatitis (AIH) is described. The infecting viral strain was of genotype Ib and the pre-treatment HCV viral load was at a high level. The patient was treated with pegylated IFN-alpha 2b and ribavirin,and her HCV-RNA became negative at wk 12,but after that she developed fulminant hepatic failure. The patient recovered after steroid pulse therapy consisting of methylprednisolone 1000 mg/d for three days which was administered twice. A needle liver biopsy revealed the typical pathological findings of AIH.     

Treatment of hepatitis C virus infection

Acute and chronic hepatitis C virus （HCV） infection remains a serious health problem worldwide, however, there has been advancement in the treatment of HCV infection due to standard treatment using pegylated interferon and ribavirin. The literature indicates that therapy for HCV is becoming more individualized. In addition to considering genotype and viral RNA levels before treatment, achievement of an early virologic response （EVR） and a rapid virologic response （RVR） is now possible during therapy. Moreover, problem patients, such as non-responders, relapsers, HIV or HBV coinfected patients, patients with liver cirrhosis, and preor post-liver transplantation patients are an increasing fraction of the patients requiring treatment. This article reviews the literature regarding standard treatments and problem patients with acute and chronic HCV infection. It also includes discussion on contraindications and side effects of treatment with interferon and ribavirin, as well as new drug development.     

利巴韦林联合炎琥宁治疗手足口病60例疗效观察

目的：观察利巴韦林联合炎琥宁治疗手足口病的疗效。方法：将60例手足口病患儿分为两组,对照组用利巴韦林治疗,治疗组用利巴韦林加炎琥宁。结果：两组有效率经χ2检验,P〈0.05,差异有显著性,治疗组有效率高于对照组。结论：利巴韦林联合炎琥宁治疗手足口病有明显效果,且炎琥宁为中成药,不良反应少,值得推荐。     

A randomized study on Peg-interferon alfa-2a with or without ribavirin in liver transplant recipients with recurrent hepatitis C

BACKGROUND/AIMS: We performed a randomized trial on pegylated interferon alfa-2a (Peg-IFNalpha) monotherapy vs Peg-IFNalpha and ribavirin in non-cirrhotic liver transplant recipients with recurrent hepatitis C. METHODS: Forty-two patients transplanted for HCV-related cirrhosis 12-96 months earlier were randomized to Peg-IFNalpha monotherapy (180 microg weekly) or Peg-IFNalpha and ribavirin, up to the maximum tolerated dose, for 48 weeks. RESULTS: Early virological response (EVR, i.e., HCV-RNA2 log drop at week 12) occurred in 76% of the monotherapy and 71% of the combination groups, respectively (intention-to treat). Sustained virological response (SVR) occurred in 8 (38%) and 7 (33%) patients, respectively. EVR had a positive predictive value for SVR of 50% and 47%, respectively, and a 100% negative predictive value in both groups. Six drop-outs occurred in the monotherapy (including 3 rejections) and 7 in the combination groups (including one rejection). Peg-INFalpha dose was reduced in 7 and 8 patients, respectively. The average daily dose of ribavirin was 435 mg/day. CONCLUSIONS: Peg-IFNalpha-2a, with or without ribavirin, induces SVR in one-third of transplant recipients with recurrent hepatitis C. Treatment cessation is indicated in patients without EVR. The low SVR rate is mainly due to inability to sustain full doses of antivirals and lack of the booster effect of ribavirin.     

利巴韦林对肠道病毒体外抑制作用的研究

目的研究抗病毒药物利巴韦林体外抗肠道病毒（EV）的效果。方法采用细胞病变效应（CPE）法和MTT分析法,观察利巴韦林对肠道病毒（EV71、CAV16、CBV3、ECH011、EV84）的抑制作用。结果利巴韦林对Vero细胞的半数毒性浓度（TC50）为2．09mg／mL,0．2mg／mL浓度的利巴韦林对5种肠道病毒均有抑制作用,对CAV16、EV71、ECHO11、EV84、CBV3的抑制率分别为13％、27％、36％、23％、58％。对EV84、EV71病毒,利巴韦林浓度为0．1mg／mL时其抑制率为16．5％、29．5％;对CBV3病毒,利巴韦林抗病毒作用与其剂量呈正相关,半数有效浓度（IC50）为0．125mg／mL,治疗指数（TI）为16．72。结论利巴韦林在体外对肠道病毒具有抑制作用,对不同的肠道病毒其抑制效率不同,对CVB3的抑制率较高。