聚乙二醇干扰素联合利巴韦林治疗难治性慢性丙肝疗效分析

目的：探讨聚乙二醇干扰素a-2a与利巴韦林联合治疗难治性丙型肝炎的临床效果及影响因素。方法随机选择2012年1月—2015年12月间在该院住院治疗的40例难治性慢性丙型肝炎(难治性丙肝),给予聚乙二醇干扰素a-2a 180 g,每周一次皮下注射,疗程48~72周(只有出现快速应答RVR时疗程为48周)；利巴韦林800~1200 mg/d,分2次口服。观察延长疗程后难治性丙肝的不同应答对治疗效果的影响,以及丙肝的分型、病毒载量、初次与复治、性别、感染途径对治疗的影响。结果在40例难治性慢性丙型肝炎中,获得RVR、cEVR、PR、DVR、NR应答的患者SVR分别为90%、81.8%、42.9%、62.5%和0%,合计70%,RVR、cEVR明显高于与PR DVR NR(P<0.05)。非1型SVR的81.25%显著高于基因1型SVR的62.5%(P<0.05)；低载量SVR为86.7%显著高于高载量的60%(P<0.05)；初次治疗SVR患者为77.42%显著高于再次治疗的44.44%,差异有统计学意义(P<0.05)。结论聚乙二醇干扰素a-2a联合利巴韦林治疗难治性慢性丙型肝炎患者,可根据应答指导治疗,可以获得更高的SVR,是一个有效的治疗方法。

Analysis of Efficacy of Pegylated Interferon Combined with Leigh Bhave Lin in the Treatment of Refractory Chronic Hepatitis C

Objective To investigate the clinical effect and influencing factors of Peg interferon a-2a combined with Rib-avirin in the treatment of refractory hepatitis C. Methods 40 cases patients with intractable chronic hepatitis C were ran-dom selected from our hospital. Thepetients was given peginterferon a-2a 180 μg weekly subcutaneous injection for 48~72 weeks(only a quick response RVR for 48 weeks);and ribavirin 800~1 200 mg/day, orally 2 times. Furthermore, the effects of different responses on prolonged treatment of refractory hepatitis C and the type and viral load hepatitis C, initial and re-treatment, sex and infective route of were observed. Results The 40 patients with refractory hepatitis C got SVR response with RVR, cEVR, PR, DVR, NR were 90%, 81.8%, 42.9%, 81.8%and 0% respectively after treatment. The total was 70%. cEVR and RVR were significantly higher than that of NR、DVR、NP (P< 0.05), Non genotype 1 SVR 81.25% was signifi-cantly higher than that of genotype 1 SVR 62.5% (P< 0.05), low load SVR 86.7% was significantly higher than that in the high loading of 60% (P< 0.05),initial treatment 77.42% was significantly higher than the treatment again in 44.44% SVR (P < 0.05). Conclusion The patients with Refractory hepatitis C treated with peg interferon a-2a combined with ribavirin can get a higher SVR according to the response to guide treatment, which is an effective treatment method.