中华实验和临床病毒学杂志
中華實驗和臨床病毒學雜誌
중화실험화림상병독학잡지
CHINESE JOURNAL OF EXPERIMENTAL AND CLINICAL VIROLOGY
2012年
4期
304-306
,共3页
张璐%申戈%张艳丽%邱国华%路遥%赵辉%杨民%李明慧%谢尧%成军%徐道振
張璐%申戈%張豔麗%邱國華%路遙%趙輝%楊民%李明慧%謝堯%成軍%徐道振
장로%신과%장염려%구국화%로요%조휘%양민%리명혜%사요%성군%서도진
肝炎,丙型,慢性%利巴韦林%干扰素类
肝炎,丙型,慢性%利巴韋林%榦擾素類
간염,병형,만성%리파위림%간우소류
Hepatitis C,chronic%Libavirin%Interferens
目的 探讨慢性丙型肝炎干扰素治疗失败患者的再治疗获得持续病毒学应答(SVR)的方案.方法 回顾54例慢性丙型肝炎干扰素治疗失败患者所采用的PEG-IFN α联合利巴韦林标准治疗或强化方案再治疗方案,比较SVR率的差异并进行统计学分析,讨论标准治疗或强化方案的适用人群.结果 54例慢性丙型肝炎干扰素治疗失败患者,再治疗后SVR率可达75.92％.其中复发者再次治疗SVR率为88.46％,无应答者再治疗SVR率64.29％.在初始普通干扰素治疗失败组、普通干扰素联合利巴韦林失败组、单用PEG-IFN α-2a失败组,再治疗后SVR率分别为95.45％、64.71％、60％.初治复发患者再治疗SVR率明显高于初治无应答患者.结论 初治失败的慢性丙型肝炎患者选择标准或强化方案再治疗仍可获得60％～90％的SVR率.初始治疗单用普通干扰素失败或普通干扰素联合利巴韦林治疗复发患者可选择标准方案再治疗；初始治疗采用普通干扰素联合利巴韦林治疗无应答、单用PEG-IFN α-2a无应答及初始治疗选用标准治疗失败患者需选择强化方案再治疗.
目的 探討慢性丙型肝炎榦擾素治療失敗患者的再治療穫得持續病毒學應答(SVR)的方案.方法 迴顧54例慢性丙型肝炎榦擾素治療失敗患者所採用的PEG-IFN α聯閤利巴韋林標準治療或彊化方案再治療方案,比較SVR率的差異併進行統計學分析,討論標準治療或彊化方案的適用人群.結果 54例慢性丙型肝炎榦擾素治療失敗患者,再治療後SVR率可達75.92％.其中複髮者再次治療SVR率為88.46％,無應答者再治療SVR率64.29％.在初始普通榦擾素治療失敗組、普通榦擾素聯閤利巴韋林失敗組、單用PEG-IFN α-2a失敗組,再治療後SVR率分彆為95.45％、64.71％、60％.初治複髮患者再治療SVR率明顯高于初治無應答患者.結論 初治失敗的慢性丙型肝炎患者選擇標準或彊化方案再治療仍可穫得60％～90％的SVR率.初始治療單用普通榦擾素失敗或普通榦擾素聯閤利巴韋林治療複髮患者可選擇標準方案再治療；初始治療採用普通榦擾素聯閤利巴韋林治療無應答、單用PEG-IFN α-2a無應答及初始治療選用標準治療失敗患者需選擇彊化方案再治療.
목적 탐토만성병형간염간우소치료실패환자적재치료획득지속병독학응답(SVR)적방안.방법 회고54례만성병형간염간우소치료실패환자소채용적PEG-IFN α연합리파위림표준치료혹강화방안재치료방안,비교SVR솔적차이병진행통계학분석,토론표준치료혹강화방안적괄용인군.결과 54례만성병형간염간우소치료실패환자,재치료후SVR솔가체75.92％.기중복발자재차치료SVR솔위88.46％,무응답자재치료SVR솔64.29％.재초시보통간우소치료실패조、보통간우소연합리파위림실패조、단용PEG-IFN α-2a실패조,재치료후SVR솔분별위95.45％、64.71％、60％.초치복발환자재치료SVR솔명현고우초치무응답환자.결론 초치실패적만성병형간염환자선택표준혹강화방안재치료잉가획득60％～90％적SVR솔.초시치료단용보통간우소실패혹보통간우소연합리파위림치료복발환자가선택표준방안재치료；초시치료채용보통간우소연합리파위림치료무응답、단용PEG-IFN α-2a무응답급초시치료선용표준치료실패환자수선택강화방안재치료.
Objective To explore the retreatment of CHC patients with initial treatment failure and how to achieve SVR.Methods 54 patients who had experienced treatment failure were enrolled and retreated with standard treatment of pegylated interferon and ribavirin or intensive treatment,respectively.Their SVR rates were statistically compared,to decide two therapies' application.Results 54 patients had been retreated,and total SVR rate was up to 75.92％,with 88.46％ in relapsed patients and 64.29％ in non-responders.After retreatment with pegylated interferon and ribavirin,SVR rate was 95.45％ in patients with prior interferon monotherapy,and 64.71％ in patients with prior interferon and ribavirin,and 60％ in patients with prior pegylated interferonα-2a monotherapy.SVR rate of relapsed patients was significantly higher than that of non-responders.Conclusions In CHC patients with treatment failure,SVR rate of retreatment with standard treatment or intensive treatment still can be up to 60％-90％.Retreatment with standard therapy can be applied to patients who had received interferon monotherapy or interferon plus ribavirin.Three types of patients who need intensive retreatment were as following:patients nonresponsive to interferon plus ribavirin or pegylated interferon α-2a monotherapy,and patients with treatment failure who had received prior standard treatment.
