干扰素治疗慢性丁型肝炎

近5年来,有不少文章报道了用α干扰素治疗慢性乙型和丙型肝炎对照试验的结果。目前该药已广泛用于这些常见肝病的治疗。本文着重介绍最近Farci等使用α干扰素治疗慢性丁型肝炎的效果。 该研究将病人分为三组:(1)大剂量组:每周使用α干扰素3次,每次9MU;(2)小剂量组:每周使用α干扰素3次,每次3MU;(3)未治疗组。结果表明,本研     

对慢性丙型肝炎患者增加干扰素剂量不能改善治疗反应

目前,对常规应用干扰素(3MU,每周3次)12周后无反应的慢性丙型肝炎患者的治疗意见仍然不一。有人认为,常规应用干扰素连续治疗3个月不发生反应者应停止治疗;也有人主张增加干扰素剂量(至5～6MU,每周3次),以改善治疗反应。然而,作者的研究结果表明,对常规干扰素治     

干扰素治疗慢性丙型肝炎应答的预测因素

为进一步澄清干扰素治疗慢性丙型肝炎应答的预测因素,作者在1988年4月～1991年12月间对111例接受干扰素(IFN)治疗的慢性丙型肝炎患者的几种变异因素的预测价值进行了单变量和多变量分析研究。 全部病例均接受α-2a IFN治疗。Ⅰ组(17例):2 MU,每周3次,共16周(总剂量96 MU),肌注。Ⅱ组(25例):4MU,每周3次,共16周(总剂量192MU)。Ⅲ组(47例):6MU,每周3次,共16周(总剂量288MU)。Ⅳ组(22例):6MU,每周6次,共2周;随后每周3次,共22周(总剂量468MU)。ALT在治疗期间或治     

α-干扰素治疗慢性丙型肝炎的效果主要取决于RNA水平

尽管α-干扰素(IFN-α)已用于治疗慢性丙型肝炎(CHC),但很少病人有长期效应。本文作者研究了与IFN疗效有关的几个因素:丙型肝炎病毒(HCV)基因型、RNA水平、组织学特征、IFN剂量、生物化学标记及年龄等。 选择抗-HCV阳性(ELISA-2)但无肝硬变的活动性CHC病人60例,其中35例(1组),用人淋巴母细胞IFN治疗,5MU,每周3次,疗程24周(总量360MU);另25例(2组)先用5MU,每周3次,治疗12周,然后用2.5MU,每周3次,疗程24周(总剂量     

慢性丙型肝炎患者对干扰素治疗的反应性与肿瘤坏死因子α基因的表达

最近的研究发现,慢性丙型肝炎患者血清中肿瘤坏死因子α(TNF-α)水平升高,本文作者的研究目的是探讨慢性丙型肝炎患者对IFN-α治疗的反应性与TNF-α产生之间的关系。 研究对象分为3组:第1组为47例慢性丙型肝炎患者和17例正常对照,检测血清TNF-α水平。其中16例未经治疗,31例进行了不同剂量的全程IFN-α治疗(3MU/天×2个月和3MU,3次/周×8～12个月),第2组为61例慢性丙型肝炎患者的71份外周血单     

重组α-干扰素治疗儿童慢性丙型肝炎

已证实α-干扰素治疗成人慢性丙型肝炎有效,ALT复常率在40～70％,而且停止治疗后ALT正常者仍有10～30％,儿童丙型肝炎虽少见,也可考虑用抗病毒治疗。近期的一项非对照试验已显示α-干扰素治疗儿童慢性丙型肝炎6个月后(一疗程)有相当比例患儿ALT恢复正常,具有良好的耐受性。因此,作者进行了小规模的随机对照研究以评价重组α-干扰素12个月一疗程治疗儿童慢性丙型肝炎的效果。 1991年4月至1992年6月,对27例慢性丙型肝炎患儿(年龄2～14岁)进行研究。ALT异常6个月以上,治疗前1年内肝活检显示19例为慢性活动性肝炎,8例为慢性迁延性肝炎。HCV RNA阳性22例。随机对照试验分两组,治疗组14例,用重组α-2b干扰素5MU/m~2,每周3次,连用4个月,如ALT下降50％以上者治疗延续到12个月。对照组13例未用干扰素。     

结核感染后慢性丙型肝炎痊愈

作者报道一例慢性丙型肝炎患者对干扰素和利巴韦林治疗无反应,而在肺结核复发后肝炎获得痊愈。 患者女性、27岁,实验室技术员。1989年曾因肺结核应用抗痨药物治疗1年。1995年7月被针头刺伤后发生急性丙型肝炎,因患者的血清转氨酶水平持续升高,同年12月行肝活检进一步确诊,并应用干扰素(3MU,每周3次)治疗6个月。但此后血清HCVRNA仍为阳性,ALT波动在64～203U/L。1998年2月第二次肝活检示慢性丙型肝炎(Knodell指数为5,纤维化评分为1),病毒基因分型为1b,病毒负荷为300 000拷贝/     

大剂量重组α或γ干扰素治疗慢性丙型肝炎的随机对照试验

慢性丙型肝炎(CHC)因其没有有效的治疗方法而往往成为一种进行性肝脏疾病。本文研究的目的旨在评价长期大剂量(约15MU)应用重组α干扰素2C(rIFN-α2C)对CHC的疗效和重组Υ干扰素(rIFN-Υ)对CHC的潜在效果。作者把50例患者随机分为3组。第1组(10例)按7.5MU/m~2体表面     

派罗欣联合利巴韦林治疗慢性丙型肝炎的早期不良反应观察及处理

目的 观察派罗欣(聚乙二醇干扰素α-2a)联合利巴韦林治疗的慢性丙型肝炎患者的早期不良反应.方法 回顾性分析了58例应用派罗欣联合利巴韦林治疗的慢性丙型肝炎患者治疗4周的临床资料.结果 派罗欣联合利巴韦林治疗的早期不良反应有发热40例(69%),头痛及肌肉关节酸痛36例(62%),胃肠道反应10例(17%),白细胞(WBC)减少44例(76%),血小板(PLT)减少10例(17%),血红蛋白(HGB)下降31例(53%),4例患者因中性细胞数降低而将派罗欣减量,6例患者因胃肠道反应或HGB明显下降将利巴韦林减量.结论 派罗欣联合利巴韦林治疗慢性丙型肝炎早期最常见的不良反应是类流感样症状、胃肠道反应、白细胞、中性粒细胞、血小板减少及血红蛋白下降,中性粒细胞减少、胃肠道反应及血红蛋白下降可以导致干扰素及利巴韦林减量,从而影响丙型肝炎的抗病毒疗效.     

128例儿童慢性丙型肝炎抗病毒治疗中不良反应的观察与护理

目的探讨采用聚乙二醇干扰素联合利巴韦林抗病毒治疗儿童慢性丙型肝炎的不良反应及其护理。方法选取我院采用聚乙二醇干扰素联合利巴韦林抗病毒治疗的慢性丙型肝炎患儿128例,将其分为观察组与对照组各64例。对照组采用常规护理模式,观察组采用优质护理模式,比较两组患者的护理满意度情况。结果观察组的护理满意度为95.31%,显著高于对照组的79.69%,差异有统计学意义(P<0.05)。结论及时观察采用聚乙二醇干扰素联合利巴韦林抗病毒治疗的慢性丙型肝炎患儿的不良反应,并采取积极有效的护理措施是提高慢性丙型肝炎患儿抗病毒治疗的依从性和确保治疗成功的关键。     

干扰素在狂犬病预防中作用的观察

目的回顾性观察2008年10月-2009年10月干扰素在狂犬病预防中的作用。方法观察组全疗程注射狂犬疫苗,同时首剂疫苗注射时加用α-2b干扰素200万IU伤口局部封闭注射,300万IU肌肉注射,对照组单用狂犬疫苗或狂犬疫苗加狂犬病免疫球蛋白。比较三组人均治疗费用。追踪回访各组预防处理后第45 d狂犬病抗体阳性率及12个月内狂犬病发病数。结果第45 d查狂犬病抗体,使用干扰素组抗体阳性率94.1%,单用狂犬疫苗组抗体阳性率89.0%,狂犬疫苗加狂犬病免疫球蛋白组抗体阳性率94.8%,干扰素联合狂犬疫苗组抗体阳性率显著高于单用狂犬疫苗组（χ2=40.33,P〈0.01）,与狂犬疫苗加狂犬病免疫球蛋白组差异无统计学意义（χ2=0.811,P〉0.05）。干扰素加狂犬疫苗组及狂犬疫苗加狂犬免疫球蛋白组狂犬病发病率显著低于单用狂犬疫苗组（χ2=7.301,P〈0.01）。三组进行人均价格比较,观察组费用稍高于单用狂犬疫苗组,明显低于狂犬疫苗加狂犬病免疫球蛋白组。结论干扰素联合狂犬疫苗在狂犬病的预防中可以增加抗体阳性率,减低狂犬病发生率,且费用明显低于狂犬疫苗加狂犬病免疫球蛋白组。     

抗血小板药物联合应用在冠心病患者中的可行性与安全性分析

目的：探讨氯吡格雷联合阿司匹林抗血小板治疗冠心病老年患者的可行性和安全性。方法：选取本院2012年1月-2013年6月收治的老年冠心病患者100例,按随机数字表法分为观察组和对照组,每组各50例。对照组给予阿司匹林;观察组给予氯吡格雷联合阿司匹林。观察两组的血小板计数、血小板聚集率、出血率及凝血三项。结果：治疗后,两组血小板计数和血小板聚集率较治疗前均明显降低（P〈0．05）,出血率与治疗前比较差异无统计学意义（P〉0．05）;两组间血小板计数、出血率比较,差异无统计学意义（P〉0．05）,但在治疗6个月和12个月时,观察组血小板聚集率疗效优于对照组（P〈0．05）;两组治疗前后及两组间的凝血三项比较变化均不明显。结论：采用氯吡格雷联合阿司匹林双联疗法疗效治疗老年冠心病患者临床疗效显著,安全可行。     

Controlled trial with interferon alfa 2-b in chronic hepatitis C patients

Thirty-eight chronic hepatitis C (CHC) Egyptian patients with persistently elevated serum alanine aminotransferase (ALT) for 6 months were randomly allocated into 2 groups: Group I (19 patients) received 3 million units (MU) of interferon alpha - 2b (Intron-A) subcutaneously thrice weekly for 6 months. In group I, complete response (normalization of ALT by the end of treatment) was achieved in 8 patients (42.1%), partial response (decrease of ALT by at least 50% of the pretreatment values) in 7 patients (36.8%) and no response in 4 (21.1%). Sustained response for 6 months after the end of therapy was attained in 4 of the 8 (50%) complete responders. Thus attaining an overall sustained response in 4 of the 19 patients (21.1%). In group II, spontaneous normalization of ALT was established in 1 patient (5.3%). Repeat liver biopsies in 16 patients of the interferon group, revealed moderate improvement in the degree of lobular inflammation, hepatocyte necrosis and portal inflammation. We conclude from this study that treatment of CHC with 3 MU of IFN-alfa 2b thrice weekly for 6 months is associated with a low response rate (21.1%). To improve the results, escalation of the IFN dose and/or prolongation of the treatment period should be considered.     

Vitamin E and C supplementation prevents decrease of eicosapentaenoic acid in mononuclear cells in chronic hepatitis C patients during combination therapy of interferon alpha-2b and ribavirin

OBJECTIVE: We investigated the effects of vitamin E and C supplementation on the fatty acid composition of mononuclear cells and on the clinical observations in patients who had chronic hepatitis C and received interferon-alpha-2b (IFN-alpha-2b) and ribavirin combination therapy. METHODS: Patients were randomly allocated to receive daily 500 mg of vitamin E and 750 mg of vitamin C (vitamin group, n = 14) or no supplement (non-vitamin group, n = 16) in addition to IFN-alpha-2b and ribavirin therapy. The fatty acid composition of mononuclear cell phospholipids was analyzed before and at 2, 4, and 8 wk after treatment. RESULTS: After vitamin supplementation, plasma and red blood cell alpha-tocopherol and plasma ascorbic acid levels increased in the vitamin group. Serum levels of alanine aminotransferase decreased significantly after 2 wk of treatment in both groups. At the start of treatment, a lower level of eicosapentaenoic acid (EPA) and a higher level of the molar ratio of arachidonic acid to EPA in mononuclear cells were observed in the present patients compared with healthy volunteers, and a significant correlation between the molar ratio and serum alanine aminotransferase level was found. The EPA level of mononuclear cells was maintained in the vitamin group during treatment, whereas a significant decrease was observed in the non-vitamin group at 4 and 8 wk after treatment. CONCLUSIONS: Antioxidant vitamin supplementation during IFN-alpha-2b and ribavirin therapy prevented a decrease in EPA of mononuclear cell phospholipids. If a further decrease in the ratio of arachidonic acid to EPA can be achieved by using oral EPA supplementation, the efficacy of IFN-alpha-2b and ribavirin therapy may be improved.     

人血免疫球蛋白治疗特发性血小板减少性紫癜

[目的]观察人血免疫球蛋白治疗特发性血小板减少性紫癜(ITP)的临床疗效。[方法]将符合诊断标准的58例ITP患者随机分为观察组和对照组,每组29例。2组均给予全反式维甲酸、泼尼松片治疗:全反式维甲酸,10mg/次,3次/d,口服;泼尼松片,1mg/(d.kg体质量),3次/d,口服。观察组同时给予人血免疫球蛋白静脉滴注,400mg/(kg.d),连用5d。2组均以治疗1个月为1个疗程,治疗1个疗程后评价疗效。[结果]观察组痊愈率51.72%,总有效率96.55%;对照组痊愈率34.48%,总有效率79.31%。2组痊愈率、总有效率比较差异有统计学意义(P﹤0.05)。PAIgG、PAIgM、PAIgA等观察指标治疗后2组组间相比差异有统计学意义(P﹤0.05),2组治疗前后组内相比差异有统计学意义(P﹤0.05)。外周血CD4+CD25+T及CD4+CD25highT阳性率、血小板计数2组治疗后组间相比差异有统计学意义(P﹤0.05)。2组有效止血时间、血小板上升时间、血小板恢复正常时间相比差异有统计学意义(P﹤0.05)。[结论]人血免疫球蛋白治疗ITP疗效显著,可缩短止血时间、血小板上升时间及血小板恢复正常的时间。     

脑梗死急性期血小板膜糖蛋白及多项相关血液指标的表达变化

目的研究血小板膜糖蛋白和多项相关血液指标在脑梗死急性期患者体内的变化,探讨血小板活化在脑梗死发病与转归中的作用。方法应用流式细胞术(FCW)检测脑梗死急性期患者与健康对照组血小板膜GPⅡb/Ⅲa复合物和P-选择素。应用自动血液凝血分析仪测定脑梗死急性期患者与健康对照组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)。应用全自动血细胞分析仪测定脑梗死急性期患者与健康对照组血小板计数(PLT)、平均血小板体积(MPV)和血小板分布宽度(PDW)。结果脑梗死急性期患者血小板膜GPⅡb/Ⅲa复合物和P-选择素、PT、FIB、MPV和PDW均高于健康对照组(p<0.01);脑梗死急性期患者与健康对照组APTT的差异无统计学意义(p>0.05);脑梗死急性期患者外周血PLT较健康对照组降低(p<0.01)。结论血小板膜糖蛋白GPⅡb/Ⅲa复合物和P-选择素可作为表明血小板活化的敏感指标,在脑梗死的诊断和治疗中有着重要的意义。PT、FIB、MPV、PDW和PLT对脑梗死的诊疗有一定的提示作用。     

60例短暂性脑缺血发作患者高同型半胱氨酸干预疗效观察

目的观察具有高同型半胱氨酸血症的短暂性脑缺血发作患者,在甲钴胺及叶酸治疗后,血浆Hcy水平和TIA疗效、预后的关系。方法选60例高同型半胱氨酸血症的短暂性脑缺血发作患者随机分2组,治疗组和对照组,2组均给予常规抗血小板聚集、扩血管治疗,治疗组在此基础上给予叶酸片5mg 3次/日+甲钴胺片500ug 3次/日干预其高Hcy,连用3月。分别在入院第二天、治疗3月后采用荧光偏振免疫检测法测定2组患者Hcy水平,并进行ABCD评分、ESSEN评分,随访观察疗效、预后。结果治疗3月后治疗组血Hcy明显降低,而对照组Hcy无明显变化,两组比较差异有统计学意义(P<0.01);治疗组显效率、有效率明显高于对照组,两组比较差异有统计学意义(P<0.05)。结论甲钴胺、叶酸可降低血Hcy水平,提高TIA短期疗效、改善预后。     

Combined interferon-alfa-2b and ribavirin therapy in patients with recurrent chronic hepatitis c after liver transplantation

Interferon with ribavirin therapy has been proposed for the treatment of hepatitis C recurring in liver transplants. AIM OF THE STUDY: Was to assess the efficacy of standard combination therapy (interferon plus ribavirin) of chronic hepatitis C in transplanted patients with recurrent severe HCV induced chronic hepatitis. METHODS: 12 patients with HCV-PCR positive reaction (genotype 1b) were treated with the therapy of interferon-alpha-2b (3 MU three times a week) and 800-1000 mg ribavirin daily. Liver biopsy had been done in every patients before and after the treatment. Study endpoints were the end of treatment and the 6 month post-therapy sustained virologic response. RESULTS: At the end of treatment 3 patients were negative for HCV-PCR and all of them had negative reaction after 6 month follow-up period. CONCLUSION: The results are in a good accordance with treatment of patients with chronic hepatitis C without liver transplantation.     

小剂量阿司匹林联合硫酸镁对妊娠期高血压患者妊娠结局的影响

目的 探讨小剂量阿司匹林联合硫酸镁在妊娠期高血压患者中的临床效果及对妊娠结局的影响.方法 选择2018年6月—2020年9月山东第一医科大学附属青州医院产科收治的妊娠期高血压患者96例,随机信封随机法分为两组.两组均给予常规方法治疗,对照组48例给予硫酸镁干预,观察组48例联合小剂量阿司匹林,患者均治疗4周,比较两组血...     

Interferon-alpha and PUVA therapy for mycosis fungoides

14 patients suffering from early stage mycosis fungoides were treated with interferon alpha 2-a and PUVA/1 patient in stage I a, 3 patients in stage I b, 4 patients in stage II a and 6 patients in stage II b/during 3-21 months time course. Interferon alpha 2-a was administered 3 times a week, in escalating dose from 3 MU to 9 MU, determining the individual maximal tolerated dose. All of the patients responded well to the treatment. Partial remission was observed after 4-13 weeks of treatment. Total remission developed in 8 cases, after 8 weeks- 9 months of the treatment. Side effects occurred frequently: weight loss, pain, fever, fatigue, leucopenia, thrombopenia, liver enzyme elevation. Because of the side effects the dose of the interferon was reduced individually, the dose reduction did not cause relapse.