CAJ | 학술논문

目的观察聚乙二醇化干扰素α-2a(Peaylated interferon α-2a,peg-IFNα-2a)联合利巴韦林治疗老年慢性丙型肝炎的临床疗效.方法收集40例我院慢性丙型肝炎患者,其中老年患者(治疗组)20例,采用peg-IFNα-2a 135～180μg(个别患者维持剂量选择90μg)皮下注射,每周1次,利巴韦林600～1000 mg/d,疗程48周;成年患者(对照组)20例,采用peg-IFNα-2a 135～180μg皮下注射,每周1次;利巴韦林800～1200 mg/d,疗程48周.比较两组快速病毒学应答(RVR)率、早期病毒学应答(EVR)率、治疗结束时病毒学应答(ETVR)率、持续病毒学应答(SVR)率、无应答率及复发率,评价疗效并观察药物不良反应.结果治疗组和对照组RVR率、EVR率、ETVR率、SVR率及复发率分别为60%、70%、75%、60%、10%、10%和75%、80%、85%、75%、5%、10%,组间比较无统计学差异.与对照组相比,治疗组中性粒细胞减低率更高(P＜0.05);贫血及低血小板症,类流感样症状,胃肠道反应等不良反应,组间差异无统计学意义.结论对于老年慢性丙型肝炎患者,积极控制基础病,使用常规剂量的PEG-IFN及小剂量利巴韦林,积极处理不良反应,仍可获得较高的有效率和较好的耐受性.
목적 관찰취을이순화간우소α-2a(Peaylated interferon α-2a,peg-IFNα-2a)연합리파위림치료노년만성병형간염적림상료효.방법 수집40례아원만성병형간염환자,기중노년환자(치료조)20례,채용peg-IFNα-2a 135～180μg(개별환자유지제량선택90μg)피하주사,매주1차,리파위림600～1000 mg/d,료정48주;성년환자(대조조)20례,채용peg-IFNα-2a 135～180μg피하주사,매주1차;리파위림800～1200 mg/d,료정48주.비교량조쾌속병독학응답(RVR)솔、조기병독학응답(EVR)솔、치료결속시병독학응답(ETVR)솔、지속병독학응답(SVR)솔、무응답솔급복발솔,평개료효병관찰약물불량반응.결과 치료조화대조조RVR솔、EVR솔、ETVR솔、SVR솔급복발솔분별위60%、70%、75%、60%、10%、10%화75%、80%、85%、75%、5%、10%,조간비교무통계학차이.여대조조상비,치료조중성립세포감저솔경고(P＜0.05);빈혈급저혈소판증,류류감양증상,위장도반응등불량반응,조간차이무통계학의의.결론 대우노년만성병형간염환자,적겁공제기출병,사용상규제량적PEG-IFN급소제량리파위림,적겁처리불량반응,잉가획득교고적유효솔화교호적내수성.
Objective To study the clinical efficacy of PEG-Interferon α-2a combined with ribavirin in eldly chronic hepatitis. Methods Forty patients with chronic hepatitis C were divided into treatment group and comparative group. The twenty eldly patients of treatment group receive peg-interferon α-2a 135-180 μg subcutaneous injection every week combined with ribavirin 600-1000mg/d for 48 weeks, and twenty adult patients of control group receive peg-interferon 135-180 μg subcutaneous injection every week combined with ribavirin 800-1200 mg/d for 48 weeks. The rapid virological response(RVR) rate, early virological response(EVR) rate, end of treatment virological response (ETVR) rate, sustained virological response(SVR) rate, nonresponder rate, relapse rate and the side reaction was assessed, then to compare the differences between the two groups. Results The RVR rate, EVR rate, ETVR rate, SVR rate,nonresponder rate, relapse rate was 60% ,70% ,75% ,60% ,10% , 10% respectively, accordingly the rate in control group was 75% , 80% , 85% , 75% , 5% , 10% . The difference between the two group were not statistically significant(P ＞0.05). Compared with the control group, the rate of neutropenia was higher in treatment group(P ＜ 0.05). There was no difference between the two groups in influenza-like side effect,anemia, thrombocytopenia and gastrointestinal side reaction. Conclusions The eldly patients with Chronic Hepatitis C using general dose peg-IFNα-2a combined with lower dose ribavirin can still obtain the similar efficiency and excellent tolerance when the basic diseases such as hypertension, diabetes and side effects were treated successfully.