不同干扰素联合利巴韦林治疗慢性丙型肝炎疗效分析

目的探讨不同干扰素联合利巴韦林治疗慢性丙型肝炎(CHC)的疗效及影响疗效的因素。方法选取确诊的CHC患者156例。根据治疗方案的不同,将患者分为研究组86例和对照组70例。研究组给予聚乙二醇干扰素(PEG-IFNα-2a)联合利巴韦林治疗,对照组采用普通重组IFNα-2a联合利巴韦林治疗,疗程为48周。分别于治疗前,治疗后12、24、48、72周采集静脉血,检查肝功能、丙型肝炎病毒(HCV)基因型和HCV-RNA水平。比较2组患者相关参数的差异,并分析多种因素与疗效的相关性。结果研究组患者早期应答(ER)、完全应答(TR)和持续应答(SR)率均高于对照组,无应答(NR)率低于对照组,差异有统计学意义(P<0.05)。非Ⅰ型组患者TR率和SR率高于Ⅰ型组,部分应答(PR)率低于Ⅰ型组,差异均有统计学意义(P<0.05)。低病毒载量组患者ER、TR和SR率高于高病毒载量组,PR率低于高病毒载量组,差异均有统计学意义(P<0.05)。TR组患者年龄和肝硬化比例低于非TR组,ER率、基因非Ⅰ型和高HCV-RNA水平比例高于非TR组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄、肝硬化、ER率、基因型和HCV-RNA水平进入回归模型,均有统计学意义(P<0.05)。结论 PEGIFNα-2a联合利巴韦林是治疗CHC较理想的选择;年龄、肝硬化、ER率、基因型、HCV-RNA水平可能与其疗效有关。

Different interferon combined with ribavirin for treatment on patients with chronic hepatitis C

Objective To explore the curative effect of different interferon combined with ribavirin for treatment on pa- tients with chronic hepatitis C （CHC） and analyze the impact factors of curative effect. Methods One hundred and fifty-six patients with CHC were selected. All patients were divided into study group（ n = 86 ） and control group（ n = 70 ） according to the treatment protocols. Patients in study group were given pegylated interferon α-2a（PEG-IFNa-2a） and ribavirin;and in con- trol group were given common recombine interferon α-2a for 48 weeks. The venous blood was collected before treatment and 12,24,48,72 weeks after treatment for checking the liver function, hepatitis C virus （HCV） genotype and HCV-RNA. Then the parameters were compared between the two groups and the correlation of each factors with curative effect was analyzed. Results Compared with control group,the rate of early response（ER） ,total response（TR） and sustained response（SR） were signifi- cantly higher（ P 〈 0.05 ） while the rate of no response （NR） were significantly lower（ P 〈 0.05 ） in study group. Compared with type I group,the rate of TR and SR were significantly higher（P 〈0.05） while the rate of PR were significantly lower （ P 〈 0.05 ） in non type I group. The rate of ER, TR and SR in lower viral load group were significantly higher than those in higher viral load group, and the PR rate was significantly lower than that in higher viral load group （P 〈 0. 05 ）. The age and ra- tio of cirrhosis of patients in TR group were significantly lower while the ER rate ,the number of non type I and ratio of higher HCV-RNA were significantly higher than those in non TR group（ P 〈 0. 05 ）. Logistic regression analysis showed that age, cir- rhosis of the liver, ER rate, genotype and HCV-RNA were the main impact factors of curative effect, there were statistic differ- ences （ P 〈 0.05 ）. Conclusion The combination of PEG-IFNα-2a and ribavirin is an ideal treatment method for patients with CHC. The factors of age, cirrhosis of the liver, ER rate, genotype and HCV-RNA may be related to curative effect.