CAJ | 학술논문

目的探讨在应用聚乙二醇干扰素α-2a联合利巴韦林抗病毒治疗的慢性丙型肝炎(CHC)患者中,冷球蛋白血症对抗病毒治疗效果的影响. 方法 40例接受聚乙二醇干扰素α-2a联合利巴韦林抗病毒治疗的CHC患者进入研究,检测HCV基因型与基线、用药后4周、12周及治疗结束后24周患者血清HCV RNA水平,并检测基线患者血清中的冷球蛋白.连续型变量用独立样本t检验或秩和检验,分类资料用x2检验或Fisher' s精确概率法,对抗病毒治疗效果相关影响因素的分析用多元logistic回归分析.结果治疗4周后快速病毒学应答发生率在冷球蛋白阳性患者(6/18,33.3％)低于阴性患者(15/22,68.2％,P=0.028).冷球蛋白阳性患者的持续病毒学应答发生率也低于阴性患者(0对比6/6,P=0.012).结论冷球蛋白阳性的CHC患者快速病毒学及持续病毒学应答疗效低于冷球蛋白阴性的CHC患者.
목적 탐토재응용취을이순간우소α-2a연합리파위림항병독치료적만성병형간염(CHC)환자중,랭구단백혈증대항병독치료효과적영향. 방법 40례접수취을이순간우소α-2a연합리파위림항병독치료적CHC환자진입연구,검측HCV기인형여기선、용약후4주、12주급치료결속후24주환자혈청HCV RNA수평,병검측기선환자혈청중적랭구단백.련속형변량용독립양본t검험혹질화검험,분류자료용x2검험혹Fisher' s정학개솔법,대항병독치료효과상관영향인소적분석용다원logistic회귀분석.결과 치료4주후쾌속병독학응답발생솔재랭구단백양성환자(6/18,33.3％)저우음성환자(15/22,68.2％,P=0.028).랭구단백양성환자적지속병독학응답발생솔야저우음성환자(0대비6/6,P=0.012).결론 랭구단백양성적CHC환자쾌속병독학급지속병독학응답료효저우랭구단백음성적CHC환자.
Objective To investigate the possible influence ofcryoglobulinemia on the antiviral effect in chronic hepatitis C patients,who were treated with combination therapy of pegylated interferon alpha-2a and ribavirin.Methods Forty consecutive patients with chronic hepatitis C (CHC) were enrolled in the study.They received pegylated interferon alfa-2a (40kD,180μg/w) along with ribavirin.Baseline cryoglobulins were detected in the sera by cryoprecitation.Hepatitis C virus (HCV) genotyping was performed and HCV viral load was detected at baseline,and at 4,12 weeks during treatment,24 weeks after cessation of treatment.Results Eighteen (45.0％) patients infected with HCV were cryoglobulins positive at baseline.Mean serum HCV RNA level in cryoglobulins positive patients was higher than that in cryoglobulins negative patients (6.36±0.63 vs.5.70±1.20,P=0.032).The rapid virological response (RVR) rate was statically different between cryoglobulins positive patients and cryoglobulins negative ones (6/18,33.3％ vs.15/22,68.2％,P= 0.028).In contrast,no difference was found in early virological response (EVR) rate between the cryoglobulins positive patients and cryoglobulins negative ones (14/17,82.4％ vs.18/21,85.7％,P-1.0).Sustained virological response (SVR) rate in cryoglobulins positive and cryoglobulins negative was different (0/3,0 vs 6/6,100％,P=0.012).The rate of patients achieved RVR was different between the patients infected with HCV genotype 1 b of two groups (cryoglobulins positive:2/13,15.4％ vs cryoglobulins negative 14/21; 66.7％,P= 0.005).However,the rate of EVR in patients infected HCV genotype 1 b was not statistically different (cryoglobulins positive:9/12,75.0％ vs.cryoglobulins negative 17/20; 81.2％,P=0.647).Conclusion The rates of RVR and SVR achievement in cryoglobulinemia positive CHC patients are lower than those in cryoglobulinemia negative CHC patients.