CAJ | 학술논문

目的了解聚乙二醇干扰素治疗儿童与成人慢性肝炎近期不良反应的范围及程度,为提高抗病毒治疗的依从性提供客观依据.方法对聚乙二醇干扰素治疗的患者进行为期4周的前瞻性临床研究,并根据设计的表格对聚乙二醇干扰素治疗者的反应进行记录存档和统计学处理.结果近期不良反应包括体温升高、关节肌肉酸疼等,其中体温升高最常见,占54.11%;体温升高的程度多集中在37.3℃～38.9℃,以中、低热为主,占85.4%,到第4周时逐渐降为70%,但高热的比例却从第1周的14.5%上升到第4周的30%;43.6%的患者在第1周注射聚乙二醇干扰素后9～12 h开始发热,第3周之后多以3～5 h开始发热为主,达40%;发热持续时间,大多数患者为3～4 h;在注射后的1周中大多数患者仅发热1次,在体温升高的处理上,45.5%进行了药物降温.结论聚乙二醇干扰素治疗的近期不良反应有体温升高等,随着治疗的继续,严重程度会逐渐缓解.在不良反应中,以体温升高为主(47.6%),其他仅占1%～16.9%,发热的规律表明,发热多为一过性,50%不需要进行处理.本组患者由于采取了逐渐增加聚乙二醇干扰素量的"阶梯式"加量法,不良反应相对少且轻.
목적 료해취을이순간우소치료인동여성인만성간염근기불량반응적범위급정도,위제고항병독치료적의종성제공객관의거.방법 대취을이순간우소치료적환자진행위기4주적전첨성림상연구,병근거설계적표격대취을이순간우소치료자적반응진행기록존당화통계학처리.결과 근기불량반응포괄체온승고、관절기육산동등,기중체온승고최상견,점54.11%;체온승고적정도다집중재37.3℃～38.9℃,이중、저열위주,점85.4%,도제4주시축점강위70%,단고열적비례각종제1주적14.5%상승도제4주적30%;43.6%적환자재제1주주사취을이순간우소후9～12 h개시발열,제3주지후다이3～5 h개시발열위주,체40%;발열지속시간,대다수환자위3～4 h;재주사후적1주중대다수환자부발열1차,재체온승고적처리상,45.5%진행료약물강온.결론 취을이순간우소치료적근기불량반응유체온승고등,수착치료적계속,엄중정도회축점완해.재불량반응중,이체온승고위주(47.6%),기타부점1%～16.9%,발열적규률표명,발열다위일과성,50%불수요진행처리.본조환자유우채취료축점증가취을이순간우소량적"계제식"가량법,불량반응상대소차경.
Objective To investigate the scope and degree of short-term adverse reactions of peginterferon alfa-2a in treatment of chronic hepatitis in adults and children to provide basis for anti-viral treatment in clinical practice. Methods A prospective study was conducted in adults and children with chronic hepatitis treated with pegintefferen aifa-2a. Meanwhile, the reactions in the patients were recorded with a table designed by ourselves and statistically analyzed. Results The short-term adverse reactions included increase in body temperature and aching pain in joints and muscles. The increase in body temperature was the major reaction and accounted for 54.11%. The increase in body temperature began to appear in 47.6% of the patients. The body temperature was 37.3℃-38.9℃ in most of the patients and mediate and low increase was found in 85.4% of the patients, which was decreased to 70% in the 4th week. However, the percentage of patients with high temperature was increased from 14.5% in the 1st week to 30% in the 4th week. The increase of body temperature began to appear in 9-12 h and 3-5 h after injection of peginterferon alfa-2a in the 1st and later, respectively. The duration of fever was 3-4 h in most of the patients. It appeared once in 1 week after the rejection in most of the patients. For management of fever, coohng with medication was conducted in 45.5% of the patients. Conclusion The short-term adverse reactions in patients with chronic hepatitis treated with pegintefferon alfa-2a include the increase in body temperature etc. The severity of the adverse reactions gradually reduces with continuation of the treatment. Of the adverse reactions, the increase in body temperature is the major (47.6%) and others only account for 1%- 16.9%. The increase in body temperature is mainly transient and no management is needed in 50% of the patients. Since the "ladder-type" dose-adding method is used for administration of peginterferon alfa-2a in group of patients, the adverse reactions is low in number and mild in degree.