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目的 观察干扰素治疗复发及无应答慢性丙型肝炎时病毒动力学及丙氨酸氨基转移酶与疗效的关系。 方法 选择32例干扰素治疗后复发或无应答的慢性丙型肝炎患者 ,用复合干扰素 15 μg、每周 3次皮下注射 ,疗程 2 4周 ,检测治疗前、治疗中 1、2、3d和第 1、4、8、12、2 4周及停药后随访 6个月的丙型肝炎病毒RNA变化情况 ,判断治疗结束时应答率及随访 6个月后持续应答率及其与治疗前后病毒水平动态变化的关系。 结果 31例患者完成治疗 ,持续应答与无应答及完全应答与无应答治疗前病毒载量有明显差异 (P <0 .0 5 ) ,获持续应答者中早期病毒血症的下降较非持续应答者明显 (P <0 .0 5 ) ,治疗 12周时丙型肝炎病毒RNA阴转病例的治疗末应答及持续应答率显著高于阳性病例 (P <0 .0 5 ) ,治疗前基线丙氨酸氨基转移酶水平不影响应答情况 (P >0 .0 5 )。 结论 复发或无应答的慢性丙型肝炎干扰素治疗中 ,基线病毒载量及治疗后早期病毒水平的动态变化可作为治疗效果的预测指标。
Objective To observe the relationship between viral kinetics and alanine aminotransferase (ALT) and curative effect in patients with recurrent or non-responding chronic hepatitis C treated with interferon. Methods A total of 32 patients with chronic hepatitis C who relapsed or did not respond after treatment with interferon were treated with 15 μg interferon (IFN), 3 times a week subcutaneously for 24 weeks. Before and after treatment, The 1st, 4th, 8th, 12th, 12th, 4th week and 6 months follow-up of hepatitis C virus RNA changes, to determine the response rate at the end of treatment and follow-up 6 months after the continuous response rate and the virus before and after treatment The relationship between the level of dynamic changes. Results 31 patients completed treatment, continuous response and no response and no response to complete response and no significant difference in viral load before treatment (P <0. 05), sustained response in patients with early viremia decline than non-sustained response (P <0.05). At the 12th week of treatment, the end-of-treatment response and sustained response rate of hepatitis C virus RNA negative cases were significantly higher than those of positive cases (P0.05) Acid aminotransferase levels did not affect response (P> 0.05). Conclusion The dynamic changes of baseline viral load and early post-treatment viral levels in patients with recurrent or non-responsive chronic hepatitis C interferon may be used as predictors of treatment outcome.