摘要
目的探讨丙型肝炎肝硬化患者抗病毒治疗的持续病毒学应答（SVR）率及其影响SVR的相关因素。方法①对129例丙型肝炎肝硬化患者，根据其临床特点，予聚乙二醇干扰素α2α（PEG—IFNα2a）抗病毒治疗，利巴韦林根据患者体重予15mg／kg／d。定期监测HCVRNA，SVR率作为疗效评价主要指标，并进行统计学分析。②以SVR为因变量，性别、年龄、RNAlog值、肝硬化分期、是否初治、是否RVR为自变量进行非条件Logistics回归分析。结果①共123例完成抗病毒治疗，85例获得SVR，38例无SVR。总SVR率为69．11％（85／123），代偿期肝硬化SVR率为74．51％（76／102），失代偿期肝硬化SVR率为42．86％（9／21）。SVR组基线RNAlog值6．11±1．01拷贝／ml，无SVR组基线RNAlog值6．53±0．92拷贝／ml，t=-2．194，P=0．030，差异有统计学意义。②非条件Logistics回归方程的x2=20．673，P=0．000〈0．001，进入回归方程的自变量为RNAlog值、是否失代偿肝硬化、是否RVR。结论①丙型肝炎肝硬化进行聚乙二醇干扰素α2α联合利巴韦林抗病毒治疗的SVR率为69．11％，代偿期肝硬化SVR率74．51％高于失代偿期肝硬化SVR率42．86％。②HCVRNA定量高、肝硬化失代偿期、无RVR是丙型肝炎肝硬化抗病毒疗效的危险因素，不同性别、不同年龄、是否初治与丙型肝炎肝硬化患者抗病毒治疗SVR率无明显相关。
Objective To investigate the sustained virological response （SVR） of patients with hepatitis C cirrhosis and its related factors. Method According to their clinical characteristics, 129 patients of hepatitis C cirrhosis were injected Pegasys （Peg-IFNα2α） and ribavirin （15 mg/kg/d）. The serum HCV RNA load was detected regularly. SVR was one of the main effectiveness indicator for therapy. A statistical analysis was performed. Defined SVR was the dependent variable, gender, age, logRNA value, cirrhosis of the liver stages, treatment naive or not, with or without RVR were the independent variables. The unconditioned Logistics regression was analyzed. Results 1. There was a total of 123 patients underwent antiviral treatment. 85 cases get an SVR. The overall SVR rate was 69.11% （85/123）. The SVR rate of compensated and decompensated cirrhosis was 74.51% （76/102） and 42.86% （ 9/21 ） respectively. The HCV RNA baseline of SVR group was （6. 11 ± 1.01 ） log copies/ml, which was significantly lower than that of the group without SVR [ （6.53 ± 0. 92） log eopies/ml, t = - 2. 194, P =0. 030 ]. 2 The independent variables into the unconditioned Logistics regression equation （ X：2= 20. 673, P = 0. 000） was the logRNA, cirrhosis of the liver stages, with or without RVR）. Conclusion 1. The SVR rate of hepatitis C cirrhosis was 69. 11% by combination therapy of pegylated interferon α-2α plus ribavirin. The SVR rate of compensated cirrhosis was obviously higher than that of decompensated cirrhosis （74.51% vs. 42.86% ）. 2. Higher HCV RNA load, decompensated cirrhosis and no RVR were risk factors for SVR. The gender, age and therapy-naive or not of the hepatitis C cirrhosis was not significantly related to the rate of SVR.
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
2016年第5期477-480,共4页
Chinese Journal of Experimental and Clinical Virology
关键词
肝炎
丙型
肝硬化
持续病毒学应答
聚乙烯二醇类
利巴韦林
Hepatitis C
Liver cirrhosis
Sustained virological response （SVR）
Polyethylene glycols
Ribavirin
