聚乙二醇干扰素联合利巴韦林治疗慢性丙型肝炎临床观察

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目的:观察聚乙二醇干扰素(PEG-INFa)联合利巴韦林治疗慢性丙型肝炎临床疗效。方法:共收集42例慢性丙型肝炎患者,其中治疗组24例,采用聚乙二醇干扰素180ug皮下注射,每周1次;对照组18例,采用IFNa-2b(赛若金)500万u皮下注射,隔日1次。两组均联合利巴韦林治疗,剂量均为800~1200mg/d口服,总疗程为48周。分别于治疗12周、24周、48周及治疗结束后24周评价疗效,并观察药物副反应。结果:所有患者均完成治疗,在治疗12周时,治疗组早期应答率83.3%,对照组应答率50.0%;在治疗24周时,治疗组应答率87.5%,对照组应答率61.1%;在治疗48周时,治疗组完全应答率87.5%,对照组完全应答率55.6%;治疗结束后24周,治疗组持续应答率75.0%,对照组持续应答率44.4%。主要副反应为不同程度发热,头痛,肌肉关节酸痛,白细胞,血红蛋白及血小板下降,部分患者出现脱发,皮疹皮肤瘙痒,失眠,抑郁等症状,予对症处理后好转,未影响治疗。结论:PEG干扰素联合利巴韦林治疗慢性丙型肝炎疗效优于普通干扰素,副反应两者无明显差别,患者可以耐受。 Objective: To observe the clinical efficacy of pegylated interferon (PEG-INFa) combined with ribavirin in the treatment of chronic hepatitis C Methods: A total of 42 patients with chronic hepatitis C were collected, including 24 in the treatment group and subcutaneous injection of peginterferon 180ug once a week. In the control group, 18 patients were treated with IFNa-2b u subcutaneous injection, every other day. Both groups were treated with ribavirin, the dose was 800 ~ 1200mg / d orally, the total course of 48 weeks. The curative effect was evaluated at 12 weeks, 24 weeks, 48 ​​weeks and 24 weeks after the end of treatment respectively, and side effects were observed. Results: All patients completed the treatment. At the 12th week of treatment, the early response rate was 83.3% in the treatment group and 50.0% in the control group. At 24 weeks, the response rate was 87.5% in the treatment group and 61.1% in the control group. At 48 weeks of treatment, the complete response rate was 87.5% in the treatment group and 55.6% in the control group. The sustained response rate was 75.0% in the treatment group and 44.4% in the control group at 24 weeks after the treatment. The main side effects were fever, headache, muscle and joint pain, leucocyte, hemoglobin and thrombocytopenia. Some patients developed symptoms of hair loss, pruritus and rash, insomnia and depression. After symptomatic treatment, they did not affect the treatment. Conclusion: The efficacy of PEG interferon combined with ribavirin in the treatment of chronic hepatitis C is better than that of common interferon. There is no significant difference between the two groups in side effects, and patients can tolerate.
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