小剂量派罗欣联合利巴韦林治疗丙型肝炎肝硬化代偿期患者疗效分析

【目的】研究小剂量派罗欣联合利巴韦林治疗肝硬化代偿期慢性丙型肝炎患者的临床疗效。【方法】选取基线资料齐同的血清HCV-RNA阳性的代偿期肝硬化慢性丙型肝炎患者73例,按照治疗方案的不同分为3个组:甲组23例,男/女:10/13,口服复方鳖甲软肝片2g/次,3次/d,24周为1疗程,治疗2个疗程;乙组26例,男/女:12/14,皮下注射凯因益生150×104IU/次,隔日1次,口服利巴韦林胶囊0.6g/d,疗程48周;丙组24例,男/女:13/11,皮下注射派罗欣60μg/次,1次/周,口服利巴韦林胶囊0.6g/d,疗程48周。在治疗前、治疗后4、12、24、48周采血,化验HCV-RNA、肝纤维化4项,比较3组患者疗效,按α=0.05标准,P<0.05认为差异有统计学意义。【结果】小剂量派罗欣联合利巴韦林组在病毒学应答率方面优于其他两组,差异有统计学意义早期病毒学应答(early virological response,EVR)χ2=61.49,P<0.001;迟发病毒学应答(lated virological response,LVR)χ2=27.66,P<0.001;无病毒学应答(non virological response,NVR)χ2=23.03,P<0.001];小剂量派罗欣联合利巴韦林组在抗纤维化方面优于其他两组,血清透明质酸(hyaluronic acid,HA),Ⅲ型前胶原(typeⅢcollagen,PCⅢ),Ⅳ型胶原(typeⅣcollagen,Ⅳ-C)在治疗终点的差异有统计学意义(HA F=3.692,P=0.038;C-ⅣF=5.290,P=0.007;PCⅢF=6.153,P=0.003)。【结论】小剂量派罗欣联合利巴韦林不仅可以清除HCV,同时还能抑制纤维化进展,治疗代偿期肝硬化丙型肝炎患者的疗效肯定。

Analysis on the clinical effect of low dosage pegasys combined with ribavirin in theating compensatory period chronic hepatis C cirrhosis patients

Objective]To study the efficacy of low dose pegasys combined with ribavirin in theating compensatory period chronic hepatis C cirrhosis patients. Methods ] A totle of 73 cases serum HCV-RNA-positive chronic hepatitis C with compensated cirrhosis patients were divided into 3 groups. A group（n = 23）： male/female=10/13, treated with Fufangbiejiaruanganpian 2 g/time tid for 48 weeks. B group（n = 26）： male/female=12/14, treated with recombinant human interferon α 2b injection 150 x 104 IU/time subcutaneously every other day plus ribavirin for 48 weeks. C group（n = 24）： male/female=13/11, treated with subcutaneous 60 μg pegasys once a week plus ribavirin 0.6 g/d for 48 weeks. Serum HCV-RNA, HA, LN, C- IV, PC III were determined before treatment and after treatment 4 weeks, 12 weeks, 24weeks and 48 weeks, and statistically analysised. Results]The virological responses rate of C group was significant higher than other groups（EVR χ2=61.49, P 〈 0.001; LVR χ2=27.66, P 〈 0.001; NVR X 2=23-03, P 〈 0.001）. The efficacy of antifibrotic comparison among three groups were statistically significant at end point（HA F = 3.692, P = 0.038, C-IV F = 5.290, P = 0.007, PC III F= 6.153, P = 0.003）. Conclusion ] Low dose pegasys plus ribavirin not only can clear HCV, but can also restrain the progress of fibrosis. The curative effect of low dose pegasys plus ribavirin combination therapy is good for treating chronic hepatitis C with compensated cirrhosis patients.