中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2012年
2期
112-115
,共4页
谢玉梅%李冰%马力%潘蕾%魏欣%彭梅娟%郝春秋%张颖%白雪帆%康文臻%贾战生
謝玉梅%李冰%馬力%潘蕾%魏訢%彭梅娟%郝春鞦%張穎%白雪帆%康文臻%賈戰生
사옥매%리빙%마력%반뢰%위흔%팽매연%학춘추%장영%백설범%강문진%가전생
肝炎%丙型%肝硬化%脾切除术%干扰素α-2a%利巴韦林%持续治疗应答率
肝炎%丙型%肝硬化%脾切除術%榦擾素α-2a%利巴韋林%持續治療應答率
간염%병형%간경화%비절제술%간우소α-2a%리파위림%지속치료응답솔
Hepatitis C%Liver cirrhosis%Splenectomy%Interferon alpha-2a%Ribavirin%Sustainedvirus response
目的 观察丙型肝炎肝硬化合并脾功能亢进患者在脾切除或部分脾栓塞术后采用聚乙二醇干扰素(Peg-IFN)α-2a联合利巴韦林抗病毒治疗的疗效. 方法 将49例丙型肝炎肝硬化(基因Ⅰ型HCV感染)合并脾功能亢进而未作抗病毒治疗的患者,在行脾切除术或部分脾栓塞术,脾功能亢进改善3个月后,给予Peg-IFNα-2a 135 μg或180μg皮下注射,每周1次,联合利巴韦林800 ～ 1200 mg/d治疗,疗程48周.治疗期间,第1、2、4、6、8、12周随访,之后每4周随访1次,停药后继续观察24周.治疗及随访期间观察肝功能、血常规、肾功能、HCV RNA及用药期间的不良反应.结果 丙型肝炎肝硬化合并脾功能亢进患者采用脾切除或部分脾栓塞术治疗脾功能无进缓解后,给予Peg-IFNα-2a联合利巴韦林抗病毒治疗其持续病毒学应答率(SVR):脾切除患者为65.00％(13/20),部分脾栓塞术患者为58.62％ (17/29).结论 丙型肝炎肝硬化合并脾功能亢进的患者,在脾切除或部分脾栓塞术后给予Peg-IFN α -2a联合利巴韦林治疗有较好的SVR,延缓了丙型肝炎肝硬化的进展.
目的 觀察丙型肝炎肝硬化閤併脾功能亢進患者在脾切除或部分脾栓塞術後採用聚乙二醇榦擾素(Peg-IFN)α-2a聯閤利巴韋林抗病毒治療的療效. 方法 將49例丙型肝炎肝硬化(基因Ⅰ型HCV感染)閤併脾功能亢進而未作抗病毒治療的患者,在行脾切除術或部分脾栓塞術,脾功能亢進改善3箇月後,給予Peg-IFNα-2a 135 μg或180μg皮下註射,每週1次,聯閤利巴韋林800 ～ 1200 mg/d治療,療程48週.治療期間,第1、2、4、6、8、12週隨訪,之後每4週隨訪1次,停藥後繼續觀察24週.治療及隨訪期間觀察肝功能、血常規、腎功能、HCV RNA及用藥期間的不良反應.結果 丙型肝炎肝硬化閤併脾功能亢進患者採用脾切除或部分脾栓塞術治療脾功能無進緩解後,給予Peg-IFNα-2a聯閤利巴韋林抗病毒治療其持續病毒學應答率(SVR):脾切除患者為65.00％(13/20),部分脾栓塞術患者為58.62％ (17/29).結論 丙型肝炎肝硬化閤併脾功能亢進的患者,在脾切除或部分脾栓塞術後給予Peg-IFN α -2a聯閤利巴韋林治療有較好的SVR,延緩瞭丙型肝炎肝硬化的進展.
목적 관찰병형간염간경화합병비공능항진환자재비절제혹부분비전새술후채용취을이순간우소(Peg-IFN)α-2a연합리파위림항병독치료적료효. 방법 장49례병형간염간경화(기인Ⅰ형HCV감염)합병비공능항진이미작항병독치료적환자,재행비절제술혹부분비전새술,비공능항진개선3개월후,급여Peg-IFNα-2a 135 μg혹180μg피하주사,매주1차,연합리파위림800 ～ 1200 mg/d치료,료정48주.치료기간,제1、2、4、6、8、12주수방,지후매4주수방1차,정약후계속관찰24주.치료급수방기간관찰간공능、혈상규、신공능、HCV RNA급용약기간적불량반응.결과 병형간염간경화합병비공능항진환자채용비절제혹부분비전새술치료비공능무진완해후,급여Peg-IFNα-2a연합리파위림항병독치료기지속병독학응답솔(SVR):비절제환자위65.00％(13/20),부분비전새술환자위58.62％ (17/29).결론 병형간염간경화합병비공능항진적환자,재비절제혹부분비전새술후급여Peg-IFN α -2a연합리파위림치료유교호적SVR,연완료병형간염간경화적진전.
Objective To investigate the antiviral efficacy of combination therapy with peglyatedinterferon alpha (peg-IFNα)-2a and ribavirin (RBV) in hepatitis C patients with liver cirrhosis after splenectomy or partial splenic embolization.Methods Forty-nine hepatitis C patients with liver cirrhosis who were unable to use antiviral therapy because of hypersplenism were recruited for study and treated with splenectomy or partial splenic embolization.Three months later,a regimen of antiviral combination therapy was initiated with peg-IFNα -2a (once-weekly subcutaneous injection:135μg or 180μg) and RBV (daily oral:800 ～ 1200 mg),and was maintained for 48 weeks.The patients were followed up at treatment weeks 1,2,4,6,8,and 12.Thereafter,follow-up was conducted every four weeks.The patients were observed until 24 weeks after treatment discontinuation.Follow-up testing included liver function,blood chemistry,renal function,and HCV RNA level.Any adverse reactions were recorded.Results HLiver cirrhosis patients complicated by hypersplenism can be treated effectively with peg-IFNα -2a/RBV combination antiviral therapy after splenectomy or partial splenic embolization.The antiviral-induced sustained viral response rates was 65.00％in cirrhotic/hypersplenic hepatitis C patients receiving splenectomy and 58.62％ in those receiving partial splenic embolization.Conclusion Hypersplenism patients with hepatitis C-related cirrhosis achieved a good antiviral therapeutic effect with peg-IFNαt-2a/RBV combination therapy following splenectomy or partial splenic embolization.This sequence of treatment may help to decrease incidences of chronic hepatitis C-induced liver failure and liver cancer in these patients.
