聚乙二醇干扰素联合利巴韦林标准方案治疗慢性丙型肝炎36例临床观察

目的评价聚乙二醇干扰素（Peg—IFN）联合利巴韦林（RBV）标准方案治疗慢性丙型病毒性肝炎（CHC）的疗效与不良反应。方法采用Peg～IFN—ct2a联合RBV标准方案治疗CHC患者36例，疗程为48周，疗程结束后均随访24周。定期观察血常规、肝功能、丙型肝炎病毒（HCV）定量、甲状腺功能及临床症状变化。结果快速病毒学应答（RVR）者10例（27．8％，10／36），其中2例基因型为3型、2例为2a型；完全早期病毒学应答（complete early virological response，cEVR）者24例（66．7％，24／36）；部分早期病毒学应答（partial early virological response，pEVR）者2例（5．6％，2／36），其基因型均为1b型。复发1例（2．8％，1／36），基因型为1b型，其余均达持续病毒学应答（sustained virological response，SVR）。1例发生较严重的银屑病，于16周停药，无复发；1例反复严重口腔溃疡，RBV未全程坚持，复发。结论Peg—IFN联合RBV标准方案治疗CHC疗效较满意，可以达到较高SVR，不良反应常见，但较少影响疗程的完成，联合RBV对获得较高的SVR十分重要。

Clinical observation on combination therapy of pegylated interferon plus ribavirin standard regimen for 36 cases with chronic hepatitis C

Objective To evaluate the efficacy and side effects of combination therapy with pegylated interferon （Peg- IFN） plus ribavirin （RBV） standard regimen in the treatment of chronic hepatitis C （CHC）. Method 36 CHC patients received combination therapy of Peg- IFN- cd2a plus ribavirin （RBV） standard regimen for 48 weeks. All the patients were followed up for 24 weeks after the end of treatment. Routine blood tests, liver function tests, quantitative HCV - RNA tests, and thyroid function tests were performed and clinical symptoms were observed periodically. Results Rapid virological response （RVR） was obtained in 10 cases （27.8%, 10/36, among them were 2 cases with genotype 3 and 2 cases with genotype 2a）. Complete early virological response （cEVR） was obtained in 24 cases （66.7% , 24/ 36） and partial early virological response （pEVR） was obtained in 2 cases （5.6%, 2/36）, all of whom were genotype 1 b. Relapse was seen in 1 case whose genotype was 1 b. All the rest cases got sustained virological response （SVR）. Se- vere psoriasis was seen in 1 case and the treatment was cancelled at 16 weeks, but without relapse. Repeated severe oral ulcer was seen in 1 case, who failed to take RBV throughout the whole therapeutic cycle and who＇s disease had got re- lapsed. Conclusion Peg - IFN plus RBV standard regimen is effective for the treatment of CHC with relatively high SVR. Although the side effects are common, they seldom affect completion of the therapeutic cycle. RBV is the key for a higher SVR in the combination therapy.