聚乙二醇干扰素α-2b联合病毒唑治疗慢性丙型肝炎的临床观察

目的评价聚乙二醇干扰素α-2b联合病毒唑治疗慢性丙型病毒性肝炎的临床效果及用药安全性,探讨临床慢性丙型肝炎的抗病毒方法。方法选择68例慢性丙型肝炎患者随机分成联合治疗组与对照组,联合治疗组38例,给予聚乙二醇干扰素α-2b80μg,1次/周皮下注射,加上病毒唑450mg,3次/d,疗程为6个月;对照组30例,用甘乐能干扰素α-2b3Mu隔日肌内注射1次,加上病毒唑450mg,3次/d,疗程6个月。两组停药后随访6个月。分别观察两组慢性丙肝患者治疗前后的临床症状、体征改善状况,生化应答率、病毒应答率和临床不良反应。结果治疗结束时联合治疗组显效率、有效率和总有效率分别是71.05%、18.42%和89.47%;对照组分别是66.67%、16.67%和83.34%;两组比较差异无统计学意义（P〉0.05）。随访6个月联合治疗组的持续应答率为47.37%,而对照组为16.67%,两组有统计学意义（P〈0.01）。两组副作用均有发热、乏力、胃肠道症状、白细胞下降、肌肉酸痛等（P〉0.05）。结论聚乙二醇干扰素α-2b联合病毒唑治疗慢性丙型肝炎,可迅速缓解患者的症状体征,促进HCV-RNA的阴转,临床用安全,停药6个月后的持续完全应答显著优于甘乐能干扰素。

Clinical study of peginterferon alfa-2b combined with ribavirin in the treatment of chronic hepatitis C

Objective To evaluate the efficacy of consensus peginterferon alfa-2b combined with ribavirin therapy for chronic hepatitis C（CHC）.Methods Sixty-eight patients with CHC were randomly divided into combined curative group（n=38,PEG and ribavirin）and control group（n=30,interferon α-2b and ribavirin）,treated for 6 months and followed by a follow-up of 6 months.The end of treatment response（ETR）and end of follow-up response（sustained response,SR）were evaluated based on the main symptoms and signs and the serum ALT normalization and seronegative of HCV-RNA.Results The excellence rate,effective power and the total effective rate in combined curative group were percent of 71.0、percent of 18.42 and percent of 89.47 in turn at the end of treatment,but which in control group were percent of 66.67、percent of 16.67 and percent of 83.34,there was no significant deviation（P〉0.05）.After 6 month the rate of SR in combined curative group was percent of 47.37,while the rate was percent of 16.67 in control group（P〈0.01）.The side effects in two groups were similar which had fever,anergy,gastrointestinal symptom,leucocyte reduce,muscular soreness,and so on.Conclusion The combined treatment with Peginterferon alfa-2b and ribavirin was not only safe but also improve the forward effects.