论文部分内容阅读
目的:观察聚乙二醇干扰素α-2a(PEG-IFNα-2a)治疗慢性丙型肝炎的临床疗效和安全性。方法:85例慢性丙型肝炎患者随机分为两组,观察组(43例)予PEG-IFNα-2a 180μg,皮下注射,每周1次,同时口服利巴韦林900~1 200 mg·d-1;对照组(42例)接受普通干扰素α-2b 500MU,皮下注射,1周3次,利巴韦林用法同观察组。48周治疗结束后随访24周,检测基线及治疗4,12,48周及治疗结束后24周时的血清HCV RNA和ALT水平,比较两组快速病毒学应答(RNA)率、早期病毒学应答(EVR)率、治疗终点病毒学应答(ETVR)率、持续病毒学应答(SVR)率以及ALT复常率与不良反应。结果:EVR、ETVR、SVR观察组分别为76.7%、86.0%和79.1%,明显高于对照组的54.8%、66.7%和57.1%,差异有统计学意义(P<0.05)。观察组治疗12周及48周时ALT复常率分别为81.4%和90.7%,明显高于对照组(P<0.05)。观察组白细胞计数下降和血小板减少的发生率高于对照组(P<0.05),中性粒细胞计数减少的发生率明显高于对照组(P<0.01),其他不良反应两组相近,未出现与聚乙二醇干扰素α-2a相关的新的不良反应。结论:PEG-IFNα-2a对慢性丙型肝炎患者的疗效优于普通干扰素,并具有较好的安全性和耐受性。
Objective: To observe the clinical efficacy and safety of pegylated interferon α-2a (PEG-IFNα-2a) in the treatment of chronic hepatitis C Methods: Eighty-five patients with chronic hepatitis C were randomly divided into two groups. The observation group (n = 43) received PEG-IFNα-2a 180 μg subcutaneously once a week while receiving ribavirin 900-1,200 mg · d -1; control group (n = 42) received normal interferon α-2b 500MU subcutaneously three times a week, ribavirin use the same observation group. After 48 weeks of treatment, the patients were followed up for 24 weeks. Serum HCV RNA and ALT levels were measured at baseline and at 4, 12, 48 and 24 weeks after treatment. The rates of rapid virological response (RNA), early virological response (EVR) rate, end-of-treatment virological response (ETVR) rate, sustained virological response (SVR) rate, and ALT normalization rate and adverse reactions. Results: The EVR, ETVR and SVR observation groups were 76.7%, 86.0% and 79.1% respectively, which was significantly higher than that of the control group (54.8%, 66.7% and 57.1%, P <0.05). The ALT abnormalities in observation group at 12 and 48 weeks were 81.4% and 90.7%, respectively, which were significantly higher than those in control group (P <0.05). The incidence of decreased white blood cell count and thrombocytopenia in the observation group was higher than that in the control group (P <0.05), and the incidence of neutrophil count reduction was significantly higher in the observation group than in the control group (P <0.01). Other adverse reactions were similar New Adverse Effects Associated with Peginterferon alfa-2a. Conclusion: PEG-IFNα-2a is superior to ordinary interferon in patients with chronic hepatitis C and has good safety and tolerability.