慢性丙型肝炎合并胰岛素抵抗的抗病毒治疗临床观察

目的观察干扰素联合利巴韦林治疗慢性丙型肝炎合并胰岛素抵抗（Insulin resistance,IR）患者的疗效。方法随机选择慢性丙型肝炎患者72例,其中观察组（合并IR）38例,对照组（无IR）34例,均予聚乙二醇干扰素（PEG-IFN）α-2a联合利巴韦林治疗,疗程48周,随访12周,观察IR与干扰素疗效的相关性。结果 （1）观察组持续应答率（SVR）显著低于对照组（分别是34.2%和58.8%）,二者比较差异有统计学意义（P〈0.05）。（2）观察组中SVR组HOMA-IR治疗前显著低于非SVR组,且治疗后较治疗前显著下降,差异有统计学意义（P〈0.05）。结论合并IR降低慢性丙型肝炎抗病毒治疗的疗效,进而提示改善IR状态,有利于提高抗病毒治疗应答率。

Results of antiviral treatment of chronic hepatitis C cases complicated with insulin resistance

Objective To observe the effect of interferon and ribavirin on chronic hepatitis C patients complicated with insulin resistance.Methods Seventy-two chronic hepatitis C cases were divided into observation group（38 cases with IR） and control group（34 cases without IR）were treated with pegylated interferon（PEG-IFNα-2a）plus ribavirin for 48 weeks,then followed up for 12 weeks,the results were analyzed.Results The sustained response rate（SVR）in observation group（34.2%）was significantly lower than that of control group（58.8%）,（P0.05）.The HOMA-IR in SVR cases before treatment was significantly higher than those without SVR in observation group and significantly higher after treatment（P0.05）.Conclusions The efficacy of antiviral therapy in treatment of chronic hepatitis C patients complicated with IR would reduced suggesting that improving the IR would enhance the response rate in antiviral therapy.