CAJ | 학술논문

目的：观察聚乙二醇干扰素（Peg-IFN）α-2a联合利巴韦林对丙肝肝硬化并发脾功亢进患者在脾栓塞术或脾切除术后的抗病毒治疗效果．方法将38例丙肝肝硬化并发脾功亢进而未进行抗病毒治疗的病人，在行脾栓塞术或脾切除术，脾功能亢进改善3个月后，皮下注射90μg或135μg Peg-IFNα-2a，1周1次，并口服600～1000 mg/d利巴韦林联合治疗，持续1 a疗程．在治疗过程中，第1，4，6，8，12周随访，以后每1个月对患者随访1次，停药后继续观察半年．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．停药后继续观察半年．结果丙肝肝硬化并发脾功亢进病人使用脾栓塞或脾切除术处理脾功能缓解后，应用Peg-IFNα-2a联合利巴韦林抗病毒治疗其持续病毒学应答率为63.88%．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-IFNα-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，减少了肝衰竭及肝癌的发生．
목적：관찰취을이순간우소（Peg-IFN）α-2a연합리파위림대병간간경화병발비공항진환자재비전새술혹비절제술후적항병독치료효과．방법장38례병간간경화병발비공항진이미진행항병독치료적병인，재행비전새술혹비절제술，비공능항진개선3개월후，피하주사90μg혹135μg Peg-IFNα-2a，1주1차，병구복600～1000 mg/d리파위림연합치료，지속1 a료정．재치료과정중，제1，4，6，8，12주수방，이후매1개월대환자수방1차，정약후계속관찰반년．치료급수방기간관찰간공능、혈상규、신공능、HCV RNA급용약기간적불량반응．정약후계속관찰반년．결과병간간경화병발비공항진병인사용비전새혹비절제술처리비공능완해후，응용Peg-IFNα-2a연합리파위림항병독치료기지속병독학응답솔위63.88%．결론병형간염간경화합병비공능항진적환자，재비절제혹부분비전새술후급여Peg-IFNα-2a연합리파위림치료유교호적SVR，연완료병형간염간경화적진전，감소료간쇠갈급간암적발생．
Objective To observe the efficacy of antiviral therapy of pegylated interferon (Peg-IFN) α-2a combined with ribavirin for patients with hepatitis C cirrhosis and hypersplenism underwent splenectomy or partial splenic embolization. Methods Thirty-eight patients with hepatitis C cirrhosis (genotype Ⅰ HCV infection) hypersplenism failed to the anti-viral therapy were performed splenectomy or partial splenic embolization to improving hypersplenism. After 3 months,Peg-IFNα-2a 90μg or 135 μg was given subcutaneously once weekly, plus ribavirin 600-1 000 mg/d orally for 1 year of the treatment. During the treatment, patients were followed at four-week intervals, and then followed-up every month until the 24th week after stopping. Liver function, blood routine, renal function, HCV RNA, and adverse reaction of medication were observed during treatment and the follow-up period. Results Splenic function of patients with hepatitis C cirrhosis and hypersplenism was improved after hypersplenism splenectomy or partial splenic embolization. The sustained virologic response (SVR) rate was 63.88%after giving Peg-IFNα-2a combined with ribavirin anti-viral treatment. Conclusion After splenectomy or partial splenic embolization, patients with hepatitis C cirrhosis and hypersplenism showed the better SVR at the treatment of Peg-IFNα-2a combined with ribavirin. The treatment could delay the progress of the hepatitis C cirrhosis and reduce the incidence of liver failure and liver cancer.