CAJ | 학술논문

目的：探讨联合高压臭氧自体血回输治疗对干扰素治疗慢性丙型肝炎（CHC）患者临床疗效和不良反应的影响。方法105例 CHC 患者被分为对照组（52例，皮下注射干扰素和口服利巴韦林）和治疗组（53例，皮下注射干扰素和口服利巴韦林，联合应用高压臭氧自体血回输疗法，平均10～16次），疗程均为48周，随访24周，观察病毒学应答率和不良反应发生率。结果联合治疗组患者合并血清甘油三酯、高血压和糖尿病的发生率分别为28.3%、28.3%和28.3%，显著高于对照组的5.8%、7.7%和7.7%（P<0.05），但两组患者在性别构成比、平均年龄、肝功能、HCV RNA 载量和肝硬化患者比率等方面差异无统计学意义；治疗前后两组肝功能指标变化的差异无统计学意义；治疗组患者发热、流感样症状和血红蛋白减低发生率分别为50.9%、35.8%和34.0%，显著低于对照组的73.1%、59.6%和55.8%（x2=5.5，P<0.01；x2=5.9，P<0.01和 x2=5.0，P<0.01）；治疗组早期病毒学应答率、治疗结束时应答率和持续应答率分别为83.0%、83.0%和74.4%，与对照组相比无显著统计学差异（分别为88.5%、86.5%和76.3%）。结论尽管合并高代谢综合征，干扰素联合高压臭氧自体血回输治疗 CHC 患者病毒学应答率与对照组无显著性差异，但显著减少了不良反应发生率。高压臭氧自体血回输治疗可能成为减少干扰素不良反应的辅助疗法。
목적：탐토연합고압취양자체혈회수치료대간우소치료만성병형간염（CHC）환자림상료효화불량반응적영향。방법105례 CHC 환자피분위대조조（52례，피하주사간우소화구복리파위림）화치료조（53례，피하주사간우소화구복리파위림，연합응용고압취양자체혈회수요법，평균10～16차），료정균위48주，수방24주，관찰병독학응답솔화불량반응발생솔。결과연합치료조환자합병혈청감유삼지、고혈압화당뇨병적발생솔분별위28.3%、28.3%화28.3%，현저고우대조조적5.8%、7.7%화7.7%（P<0.05），단량조환자재성별구성비、평균년령、간공능、HCV RNA 재량화간경화환자비솔등방면차이무통계학의의；치료전후량조간공능지표변화적차이무통계학의의；치료조환자발열、류감양증상화혈홍단백감저발생솔분별위50.9%、35.8%화34.0%，현저저우대조조적73.1%、59.6%화55.8%（x2=5.5，P<0.01；x2=5.9，P<0.01화 x2=5.0，P<0.01）；치료조조기병독학응답솔、치료결속시응답솔화지속응답솔분별위83.0%、83.0%화74.4%，여대조조상비무현저통계학차이（분별위88.5%、86.5%화76.3%）。결론진관합병고대사종합정，간우소연합고압취양자체혈회수치료 CHC 환자병독학응답솔여대조조무현저성차이，단현저감소료불량반응발생솔。고압취양자체혈회수치료가능성위감소간우소불량반응적보조요법。
Objective To study the effects of ozone-enriched autologous blood transfusion on the efficacy and adverse reactions in patients with chronic hepatitis C(CHC)receiving interferon-α and ribavirin therapy. Meth-ods One hundred and five CHC patients were divided into control group and treatment group;The patients in control group (n=52) were treated with subcutaneous injection of peginterferon-α and oral administration of rib-avirin,while the patients in treatment group (n=53) were treated with combinational therapy of interferon,and rib-avirin,and ozone-enriched autologous blood transfusion (an average of 10 to 16 times). The regimen lasted for 48 weeks with a 24 week-posttreatment of follow-up. The virologic response rates and adverse reactions were observed. Results The incidence rates of serum high triglycerides levels,hypertension and diabetes in patients of treatment group were 28.3%,28.3% and 28.3%,respectively,significantly higher than those in the control patients(5.8%,7.7%and 7.7%,respectively,P<0.05);No significant differences as respect to gender,average age,liver function tests,HCV RNA load and percentage of cirrhosis were observed between the two groups;The incidence rates of fever, flu-like symptoms and reduction of hemoglobin in patients of the treatment group (50.9%,35.8% and 34.0%,respectively) were significantly lower than those in the control patients (73.1%,x2=5.5,P<0.01;59.6% x2=5.9,P<0.01 and 55.8%, x2=5.0,P<0.05);The rates of early virologic response,virologic response at end of treatment and sustained virologic response in patients in the treatment group(83.0%, 83.0% and 74.4%,respectively) were not significant-ly different from those (88.5%,86.5% and 76.3%, respectively) in the control patients. Conclusions Although some patients having metabolic syndrome, the virologic response rate in patients receiving in-terferon-α and ozone-enriched autologous blood transfusion is very high,with reduced adverse reac-tions. Ozone-enriched autologous blood transfusion may be promising in reducing interferon-α-induced adverse reactions.