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目的探讨聚乙二醇干扰素a-2a治疗难治性丙肝产生中和抗体的相关因素。方法选择2010年1月-2012年1月本院收治303例丙肝患者,分析其年龄、病程是否合并肝硬化、确定丙肝病毒类型、检测HLAA2、B7和DR2基因型,并结合患者治疗方案,同时根据患者治疗效果,判定其与患者体内中和抗体产生的关系。结果患者年龄超过50岁、病程超过3年、合并肝硬化、1型丙肝病毒感染及存在易感基因与中和抗体的产生呈正相关,规律治疗及联合利巴韦林治疗与中和抗体的产生呈负相关,其中年龄超过50岁、1型丙肝病毒感染、存在易感基因和合并肝硬化是干扰素治疗后出现中和抗体的独立危险因素。结论对于年龄超过50岁的1型丙肝病毒感染,且存在易感基因合并肝硬化的患者使用干扰素治疗时,要注意中和抗体的产生而影响治疗效果。
Objective To investigate the related factors of peginterferon alfa-2a in the treatment of refractory hepatitis C virus. Methods From January 2010 to January 2012, 303 patients with hepatitis C were admitted to our hospital for analysis of their age and course of disease with cirrhosis. HCV genotypes were determined, genotypes of HLAA2, B7 and DR2 were detected, and the patients were treated with the same treatment regimen According to the patient’s therapeutic effect, determine the relationship with the patient’s neutralizing antibody. Results Patients over 50 years of age and duration of disease over 3 years, with cirrhosis, type 1 hepatitis C virus infection and the presence of susceptibility genes and the production of neutralizing antibodies were positively correlated with regular treatment and combined ribavirin therapy and the production of neutralizing antibodies Negative correlation, of which age over 50 years, type 1 hepatitis C virus infection, presence of susceptibility genes and cirrhosis of the liver were independent risk factors for neutralizing antibodies after interferon treatment. Conclusions For interferon therapy in patients with type 1 hepatitis C virus infection over the age of 50 years and susceptible genes associated with cirrhosis, attention should be paid to the production of neutralizing antibodies to affect the therapeutic effect.