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目的探讨难治性慢性丙型肝炎(chronic hepatitis C,CHC)患者抗病毒疗效与血清趋化因子干扰素γ诱生蛋白-10(interferon-γinducible protein-10,IP-10)水平的关系。方法入组的难治性CHC患者,给予聚乙二醇干扰素联合利巴韦林治疗,评估抗病毒疗效。用Luminex技术检测基线、治疗4周和治疗12周血清趋化因子IP-10水平。结果 75例难治性CHC患者中,2例治疗至24周脱落,其余患者均完成48周治疗,随访24周,持续病毒学应答(sustained virologic response,SVR)率为68.49%(50/73)。75例难治性CHC组患者基线血清IP-10水平高于11例正常对照,差异均有统计学意义(P<0.01)。获得快速病毒学应答(rapid virologic response,RVR)者、完全早期病毒学应答(complete early virological response,cEVR)者和持续病毒学应答者基线IP-10水平显著低于未获得应答者(P=0.020,0.003,0.002)。另外比较SVR者基线、治疗4周和治疗12周IP-10水平,发现抗病毒治疗过程中,IP-10水平逐渐减低。其中治疗12周时IP-10水平明显低于基线、治疗4周,差异有统计学意义(P=0.001,0.016)。结论基线IP-10低水平有利于获得病毒学应答。获得SVR者抗病毒治疗过程中,IP-10水平显著减低。
Objective To investigate the relationship between antiviral efficacy and serum level of interferon-γinducible protein-10 (IP-10) in patients with refractory chronic hepatitis C (CHC). Methods Intractable CHC patients were treated with peginterferon combined with ribavirin to evaluate the antiviral efficacy. Baseline was measured using Luminex technology for 4 weeks and 12 weeks of serum chemokine IP-10 levels. Results Among the 75 patients with refractory CHC, 2 patients died after 24 weeks of treatment, and the remaining 48 patients were treated for 48 weeks. The sustained virologic response (SVR) rate was 68.49% (50/73) . The baseline serum IP-10 levels in 75 patients with refractory CHC were significantly higher than those in 11 normal controls (P <0.01). The baseline IP-10 levels in those with rapid virologic response (RVR), those with complete early virological response (cEVR) and those with persistent virologic response were significantly lower than those who did not (p = 0.020 , 0.003, 0.002). In addition, we compared baseline levels of SVR, IP-10 levels at 4 weeks of treatment and 12 weeks of treatment, and found that IP-10 levels gradually decreased during antiviral therapy. The IP-10 level was significantly lower than baseline at 12 weeks of treatment, and the difference was statistically significant (P = 0.001,0.016) for 4 weeks. Conclusions The low baseline IP-10 level favors the virological response. IP-10 levels were significantly reduced during antiviral therapy in SVR recipients.