聚乙二醇干扰素联合利巴韦林治疗难治性慢性丙肝疗效剖析.docVIP

聚乙二醇干扰素联合利巴韦林治疗难治性慢性丙肝疗效剖析 　　[摘要] 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800～1 200 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（P0.05）。非1型SVR的81.25%显著高于基因1型SVR的62.5%（P0.05）；低载量SVR为86.7%显著高于高载量的60%（P0.05）；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（P0.05）。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。 　　[关键词] 难治性丙型肝炎；聚乙二醇干扰素；利巴韦林 　　[中图分类号] R512.63 [文献标识码] A [文章编号] 1674-0742（2016）12（b）-0130-04 　　Analysis of Efficacy of Pegylated Interferon Combined with Leigh Bhave Lin in the Treatment of Refractory Chronic Hepatitis C 　　ZHAO Zhi-feng，JIAO Hong-bo， ZHOU Han，LIU Zhong-sheng， TU Ya，GAO Lan-zhu 　　Inner Mongolia Tongliao City Infectious Disease Hospital Liver Area ， Tongliao ， Inner Mongolia，028000 China 　　[Abstract] Objective To investigate the clinical effect and influencing factors of Peg interferon a-2a combined with Ribavirin in the treatment of refractory hepatitis C. Methods 40 cases patients with intractable chronic hepatitis C were random 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 retreatment， 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 significantly higher than that of genotype 1 SVR 62.5% （P 0.05）， lo