PEG-IFNα-2a、利巴韦林联合熊去氧胆酸治疗慢性丙型肝炎

目的观察聚乙二醇干扰素α-2a（PEG-IFNα-2a）、利巴韦林（RBV）联合熊去氧胆酸治疗慢性丙型肝炎（CHC）的临床疗效及安全性。方法对我科收治的85例CHC患者随机分为观察组和对照组,对照组42例给予PEG-IFNα-2a联合RBV治疗,观察组43例在此基础上,加用熊去氧胆酸治疗,观察两组治疗前后病毒学应答情况及不良反应发生情况。结果观察组和对照组基因Ⅰ型快速病毒学应答率（PVR）（6.5%vs 6.9%）、早期病毒学应答率（EVR）（61.3%vs 62.1%）、持续病毒学应答率（SVR）（48.4%vs 51.7%）及非基因Ⅰ型PVR（8.3%vs 15.4%）、EVR（75.0%vs 76.9%）、SVR（66.7%vs69.2%）组间比较均未见显著差异（P〉0.05）;治疗12 w时,观察组AST及TBIL恢复率明显高于对照组（P〈0.05）;治疗24 w至治疗结束后24 w,观察组ALT、AST、TBIL及GGT恢复率均显著高于对照组（P〈0.05）;两组不良反应发生率未见明显差异（P〉0.05）。结论 PEG-IFNα-2a、利巴韦林联合熊去氧胆酸可显著改善患者肝功能指标,促进肝功能恢复,安全可靠,但对病毒学应答指标没有显著作用。

Treatment of chronic hepatitis C with PEG-IFNa-2a,ribavirin combined and ursodeoxycholic acid

Objective To observe the clinical effects and safety of pegylated interferon α-2a （PEG-IFNα-2a）, ribavirin （RBV） combined with ursodeoxycholic acid in treatment of chronic hepatitis C （CHC）. Methods Total 85 patients with CHC receiving treatment in our department were divided randomly into observation group （n =42） and control group （n =43）. PEG-IFNα- 2a combined with RBV was administered to the control group, on the basis of which, ursodeoxycholic acid was administered to the observation group additionally. And then,the virological responses and adverse reactions in both groups before and after the treatment were observed. Results In the observation group and control group, for type I genes,the rate of rapid virological response （PVR） was 6.5 % and 6.9%, the rate of early virological response （EVR） was 61.3 % and 62.1%, and the rate of sustained virological response （SVR） was 48.4% and 51.7% ,respectively;for type I non-gene,the rate of PVR was 8.3% and 15.4% ,the rate of EVR was 75.0% and 76.9%, and the rate of SVR was 66.7% vs 69.2%, respectively. The two groups showed no significant difference （ P 〉 0.05）. After the treatment of 12 weeks, AST and TBIL recovery rates in the observation group were significantly higher than those in the control group （ P 〈 0.05 ） ; after the treatment of 24 weeks and after 24 weeks since the treatment was completed, the ALT, AST, TBIL and GGT recovery rates in the observation group were significandy higher than those in the control group （ P 〈 0.05 ）, and the incidence of adverse reactions had no significant difference between the two groups （P 〉 0.05）. Conclusion PEG-IFNα-2a, RBV combined with ursodeoxycholic acid can improve significantly the liver function index of the patients and promote the recovery of liver function;it is safe and reliable,but has no significant effect on virological response index.