小剂量干扰素联合苦参素和利巴韦林治疗丙型肝炎肝硬化失代偿期患者的观察

目的：观察丙型肝炎肝硬化失代偿期患者行个体化抗病毒治疗的疗效。方法：16例观察对象采用小剂量α-2b干扰素联合苦参素、利巴韦林治疗。初始剂量为干扰素100万IU,隔日1次,肌内注射,苦参素600mg/d,利巴韦林用量为600～1000mg/d。2周后将耐受良好的15名患者干扰素的剂量提高到300万IU,隔日1次,注射24周;其中13例患者继续抗病毒治疗至48周,分别随访24周。结果：16例患者中15例坚持抗病毒治疗24周,13例抗病毒治疗48周,对比治疗前后的变化。经过治疗,16例患者的纳差、腹胀症状得到不同程度的缓解;治疗结束时的肝功能（ALT、AST、ALB、TB）指标、凝血指标（PTA）、病毒学指标均得到明显改善（P〈0.05）;治疗至48周患者随访24周时与治疗结束时相比,各指标比较差异无统计学意义（P〉0.05）。结论：对丙型肝炎肝硬化失代偿期患者行小剂量干扰素逐渐加量联合苦参素、利巴韦林的个体化治疗,可延缓病情进展。

Observation on low-dose Interferon combining with Oxymatrine and Ribavirin in treatment of decompensative hepatic cirrhosis C

Objective： To study the efficacy of individualized antiviral therapy to patients with decompensative hepatic cirrhosis C. Methods： 16 patients were treated with low-dose Interferon α-2b combining with Oxymatrine and Ribavirin. Initial dose of interferon 1 million IU, every other day 1 time, Intramuscular, Oxymatrine 600 mg/d, Ribavirin 600-1 000 mg/d. 2 weeks later, the 15 patients tolerated Interferon dose Increased to 3 million IU, 1 injection every other day for 24 weeks. Among them, 13 patients continued antiviral therapy to 48 weeks, were followed up for 24 weeks. Results： 15 cases in 16 patients adhered to antiviral therapy for 24 weeks, 13 cases of 48 weeks of antiviral therapy, the changes before and after treatment were compared. After treatment, 16 patients with anorexia, abdominal distension symptom relief of different degrees. End of the treatment of liver function （ALT, AST, ALB, TB） indicator, coagulation parameters （PTA）, virological parameters were significantly improved （P0.05）. To 48 weeks of treatment were followed up for 24 weeks, compared with the end of treatment, there was no difference （P0.05）. Conclusion： Gradually increased low-dose Interferon combining with Oxymatrine and individualized Ribavirin in treatment of decompensative hepatic cirrhosis C can delay disease progression.