摘要
目的探讨聚乙二醇干扰素a-2a与利巴韦林联合治疗难治性丙型肝炎的临床效果及影响因素。方法随机选择2012年1月—2015年12月间在该院住院治疗的40例难治性慢性丙型肝炎（难治性丙肝）,给予聚乙二醇干扰素a-2a180 g,每周一次皮下注射,疗程48-72周（只有出现快速应答RVR时疗程为48周）;利巴韦林800-1 200 mg/d,分2次口服。观察延长疗程后难治性丙肝的不同应答对治疗效果的影响,以及丙肝的分型、病毒载量、初次与复治、性别、感染途径对治疗的影响。结果在40例难治性慢性丙型肝炎中,获得RVR、c EVR、PR、DVR、NR应答的患者SVR分别为90%、81.8%、42.9%、62.5%和0%,合计70%,RVR、c EVR明显高于与PR DVR NR（P〈0.05）。非1型SVR的81.25%显著高于基因1型SVR的62.5%（P〈0.05）;低载量SVR为86.7%显著高于高载量的60%（P〈0.05）;初次治疗SVR患者为77.42%显著高于再次治疗的44.44%,差异有统计学意义（P〈0.05）。结论聚乙二醇干扰素a-2a联合利巴韦林治疗难治性慢性丙型肝炎患者,可根据应答指导治疗,可以获得更高的SVR,是一个有效的治疗方法。
Objective To investigate the clinical effect and influencing factors of Peg interferon a-2a combined with Ribavirin in the treatment of refractory hepatitis C. Methods 40 cases patients with intractable chronic hepatitis C were random selected from our hospital. Thepetients was given peginterferon a-2a 180 μg weekly subcutaneous injection for 48-72weeks（only a quick response RVR for 48 weeks）;and ribavirin 800-1 200 mg/day, orally 2 times. Furthermore, the effects of different responses on prolonged treatment of refractory hepatitis C and the type and viral load hepatitis C, initial and retreatment, sex and infective route of were observed. Results The 40 patients with refractory hepatitis C got SVR response with RVR, c EVR, PR, DVR, NR were 90%, 81.8%, 42.9%, 81.8% and 0% respectively after treatment. The total was 70%.c EVR and RVR were significantly higher than that of NR、DVR、NP（P〈0.05）, Non genotype 1 SVR 81.25% was significantly higher than that of genotype 1 SVR 62.5%（P〈0.05）, low load SVR 86.7% was significantly higher than that in the high loading of 60%（P〈0.05）,initial treatment 77.42% was significantly higher than the treatment again in 44.44% SVR（P〈0.05）. Conclusion The patients with Refractory hepatitis C treated with peg interferon a-2a combined with ribavirin can get a higher SVR according to the response to guide treatment, which is an effective treatment method.
出处
《中外医疗》
2016年第35期130-133,共4页
China & Foreign Medical Treatment
