干扰素联合利巴韦林治疗不同病毒基因型慢性丙型肝炎患者的疗效

目的 观察干扰素联合利巴韦林治疗不同病毒基因型慢性丙型肝炎的疗效.方法 选择120例慢性丙型肝炎患者,采用特异性探针杂交法进行丙型肝炎病毒基因分型,根据基因分型结果将患者分为丙型肝炎病毒1b型感染的长效干扰素组(皮下注射聚乙二醇干扰素α-2a,180 μg/次,1次/周)和非1b型感染的普通干扰素组(皮下注射普通干扰素α-2b,5 mIU/次,隔日1次),2组患者均口服利巴韦林.治疗前后和随访中检测患者血浆丙型肝炎病毒RNA和ALT水平作为疗效评价的指标.比较治疗结束后2组患者肝功能异常率的差异.结果 长效干扰素组与普通干扰素组获得持续病毒学应答者分别为30例(46.2％)和41例(74.5％),组间比较差异有统计学意义(P＜0.05).长效干扰素组肝功能异常者10例(15.4％),普通干扰素组有8例(14.5％),2组患者肝功能异常率比较差异无统计学意义(x2=0.01,P＞0.05).结论 聚乙二醇干扰素α-2a联合利巴韦林治疗丙型肝炎病毒1b型感染患者的疗效不理想,丙型肝炎病毒基因型主要影响治疗的难易程度.

Efficacy of interferon alpha with ribavirin for treatment of different virus genotype chronic hepatitis

Objective To observe the clinical effect of interferon-α combined with ribaririn treatment in chronic hepatitis C patients.Methods Totally 120 patients were divided into two groups based on drug therapies：polyethylene glycol（PEG）-interferon-plus ribavirin treatment group for hepatitis C virus （HCV）1 b and interferonplus ribavirin treatment group for non-HCV-1b.Serum alanine transaminase（ALT） levels and HCV ribonucleic acid （RNA） quantization of the patients were detected during treatment and follow-up.Results All 120 patients were treated for 48 weeks.Sustained viral response rates for PEG-interferon treatment group were 46.2% and they were 74.5% for interferon treatment group.The abnormal rate of serum ALT after the treatment showed no significant difference between HCV-1b and non-HCV-1 b patients 15.4% （10/65） vs 14.5% （8/55）,P 〉 0.05].Conclusions The effect of PEG-interferon-plus ribavirin treatment for genotype 1 b is unsatisfactory.HCV genotype main impacts the outcomes of treatment.