摘要
目的 探讨冷球蛋白血症对聚乙二醇干扰素（PegIFN） α-2a联合利巴韦林治疗基因1b型慢性丙型肝炎病毒学应答的影响.方法 连续收集2008年1月至2012年12月浙江省湖州市中心医院感染病科的60例HCV基因1b型慢性丙型肝炎患者的资料.根据是否并发冷球蛋白血症,将患者分为冷球蛋白血症阳性组（22例）和冷球蛋白血症阴性组（38例）.所有患者接受48周的180 μg PegIFNα-2a联合利巴韦林治疗,不能耐受者12周后PegIFNα-2a的剂量改为135 μg.采用,检验比较两组的快速病毒学应答（RVR）、治疗后病毒学应答（ETVR）和持续病毒学应答（SVR）.结果 冷球蛋白血症阳性组的RVR、ETVR、SVR分别为59.1％ （13/22）,81.8％ （18/22）和31.8％（7/22）,冷球蛋白血症阴性组为55.3％ （21/38）,76.3％ （29/38）和60.5％ （23/38）,两组SVR比较差异有统计学意义瓴2=4.674,P＜0.05）.对完成PegIFNα-2a 180 μg全疗程治疗的患者进行分析发现,冷球蛋白血症阴性组的RVR和SVR均高于冷球蛋白血症阳性组,但差异无统计学意义（x2=1.524和1.009,P＞0.05）.冷球蛋白血症阳性组中,9例（40.9％）患者出现PegIFNα-2a治疗后严重不良反应,而冷球蛋白血症阴性组的不良反应发生率为11例（28.9％）,两组严重不良反应发生率比较差异无统计学意义（x2=0.887,P＞0.05）.结论 冷球蛋白血症对PegIFNα-2a联合利巴韦林治疗HCV基因1b型慢性丙型肝炎的病毒学应答情况无显著影响.
Objective To investigate the virologic responses to pegylated-interferon alfa-2a （PegIFNα-2a） plus ribavirin therapy for cryoglobulinemia positive chronic hepatitis C in patients with hepatitis C virus （HCV） genotype 1 b.Methods Clinical data on 60 chronic hepatitis C patients with HCV genotype 1b were collected from Huzhou Central Hospital during January 2008 and December 2012.The patients were divided into cryoglobulinemia positive group （n =22） and cryoglobulinemia negative group （n =38）,and both received 48-week PegIFNα-2a （180 μg） plus ribavirin treatments.For those who could not tolerate the treatment,PeglFNα-2a was reduced to 135 μg from 12th week.Rapid virologic response （RVR）,end of treatment virologic response （ETVR） and sustained virologic response （SVR） in two groups were observed and compared using Chi-square test.Results RVR,ETVR and SVR in cryoglobulinemia positive group were 59.1％ （13/22）,81.8％ （18/22） and 31.8％ （7/22）,while those in cryoglobulinemia negative group were 55.3％ （21/38）,76.3％ （29/38） and 60.5％ （23/38）.There was significant difference in SVRs between two groups （x2 =4.674,P ＜ 0.05）.For those completed full course of antiviral therapy with 180 μg PegIFNα-2a,the RVR and SVR in cryoglobulinemia negative group tended to be higher than those in cryoglobulinemia positive group,but the differences were not statistically significant （x2 =1.524 and 1.009,P ＞ 0.05）.Serious adverse reactions were observed in 9 （40.9％） patients of cryoglobulinemia positive group,while in 11 （28.9％） patients of cryoglobulinemia negative group （x2 =0.887,P ＞ 0.05）.Conclusion Cryoglobulinemia may not have considerable impact on virologic responses to PegIFNα-2a plus ribavirin therapy in patients with chronic genotype 1b hepatitis C.
出处
《中华临床感染病杂志》
CAS
2014年第2期157-160,共4页
Chinese Journal of Clinical Infectious Diseases
