论文部分内容阅读
目的临床实践研究直接抗病毒药物(DAAs)治疗丙型肝炎肝硬化早期抗病毒疗效及评价其安全性。方法我院在2015年12月至2016年12月给予60例丙型肝炎肝硬化(基因1b型)患者直接抗病毒药物治疗手段,均给予干扰素+利巴韦林的药物联合方案,疗程为16周。观察患者经不同药物方案治疗后的早期抗病毒疗效以及用药安全性。结果完成16周DAAs治疗后,对全部患者均进行病毒学经检测,发现丙型肝炎病毒(HCV)转阴例数为44例(73.33%),其中5例患者在停药8周后复发(11.36%)。经DAAs治疗4周后,检测患者的谷丙转氨酶(ALT)、CK和CK-MB基本降至正常值范围内,经治疗16周时,仍维持在正常值范围内;并且BUN与CRE未出现明显性升高现象,故无须调整药物使用剂量。患者在DAAs治疗中,以恶心主要不良反应,发生率为45%(27/60),但患者均可耐受,无需停药处理。结论经临床实践研究,直接抗病毒药物治疗丙型肝炎肝硬化早期抗病毒疗效较好,可以使HCV早期转阴,并且用药后患者耐受性良好,并无明显性不良反应,表明其治疗安全性颇高,值得在治疗丙型肝炎肝硬化患者时早期采用此DAAs方案。
Objective To study the efficacy and safety of direct antiviral drugs (DAAs) in the early anti-virus treatment of hepatitis C cirrhosis. Methods In our hospital from December 2015 to December 2016, 60 patients with hepatitis C cirrhosis (genotype 1b) were treated with direct antiviral therapy, and both were given interferon plus ribavirin drug combination regimen 16 weeks. Observe the early anti-virus efficacy and medication safety of patients treated by different drug regimens. Results After 16 weeks of DAAs treatment, all patients were tested for virology, and 44 cases (73.33%) of hepatitis C virus (HCV) negative cases were found. Among them, 5 cases relapsed after 8 weeks’ withdrawal 11.36%). After 4 weeks of treatment with DAAs, alanine aminotransferase (ALT), CK and CK-MB in patients were basically reduced to the normal range and maintained within the normal range after 16 weeks of treatment; and BUN and CRE did not appear Significant increase in the phenomenon, so there is no need to adjust the dose of medication. Patients in the DAAs treatment, the main adverse reactions to nausea, the incidence was 45% (27/60), but patients were tolerated without stopping treatment. Conclusions According to the clinical practice, direct antiviral treatment of hepatitis C cirrhosis early anti-virus effect is good, can make HCV early negative, and the patient after treatment is well tolerated, and no significant adverse reactions, indicating that the treatment of safety It is worthwhile to adopt this DAAs program early in the treatment of patients with hepatitis C cirrhosis.