实用肝脏病杂志
實用肝髒病雜誌
실용간장병잡지
JOURNAL OF CLINICAL HEPATOLOGY
2014年
5期
507-510
,共4页
丁岗强%康谊%尚佳%刘俊平%魏群锋%肖二辉%曾艳丽
丁崗彊%康誼%尚佳%劉俊平%魏群鋒%肖二輝%曾豔麗
정강강%강의%상가%류준평%위군봉%초이휘%증염려
慢性丙型肝炎%干扰素α-2a%极快速病毒学应答%疗效
慢性丙型肝炎%榦擾素α-2a%極快速病毒學應答%療效
만성병형간염%간우소α-2a%겁쾌속병독학응답%료효
Hepatitis C%Interferon- alpha-2a%Extremely rapid virologic response%Efficacy
目的:观察获得极快速病毒学应答的初治基因1型慢性丙型肝炎患者,在继续接受36 w 聚乙二醇干扰素α-2a 联合利巴韦林治疗后的疗效。方法将基线 HCV RNA 水平>400000 IU/ml、接受聚乙二醇干扰素α-2a(180μg/w)联合利巴韦林(1000~1200 mg/d)治疗2 w 后 HCV RNA 阴转的基因1型慢性丙型肝炎初治患者,随机分为两组,分别接受36 w 和48 w 治疗,在停药后随访24 w,观察疗效。结果本研究共纳入40例患者,两组各20例。治疗36 w 患者在治疗结束时病毒学应答(ETVR)、持续病毒学应答(SVR)和复发率分别为100%(20例)、90%(18例)和10%(2例),治疗48 w 患者 ETVR、SVR 和复发分别为95%(19例)、90%(18例)和5.3%(1例),两组比较无统计学差异(P>0.05);在40例患者,基线 HCV RNA 水平与 SVR 呈负相关(OR=0.422,95%CI 为0.05~0.29,P=0.007);在治疗36 w 患者,基线 HCV RNA<6×107IU/ml 患者 SVR 显著高于 HCV RNA≥6×107IU/ml 患者(P=0.005),但在治疗48 w 患者,未发现这种差异(P=0.063)。结论对于基线 HCV RNA 水平>400000 IU/ml 的基因1型慢性丙型肝炎初治患者,接受聚乙二醇干扰素α-2a 联合利巴韦林治疗,如在2 w 时获得病毒学应答,治疗36 w 疗程与48 w 疗程的 SVR 相当。
目的:觀察穫得極快速病毒學應答的初治基因1型慢性丙型肝炎患者,在繼續接受36 w 聚乙二醇榦擾素α-2a 聯閤利巴韋林治療後的療效。方法將基線 HCV RNA 水平>400000 IU/ml、接受聚乙二醇榦擾素α-2a(180μg/w)聯閤利巴韋林(1000~1200 mg/d)治療2 w 後 HCV RNA 陰轉的基因1型慢性丙型肝炎初治患者,隨機分為兩組,分彆接受36 w 和48 w 治療,在停藥後隨訪24 w,觀察療效。結果本研究共納入40例患者,兩組各20例。治療36 w 患者在治療結束時病毒學應答(ETVR)、持續病毒學應答(SVR)和複髮率分彆為100%(20例)、90%(18例)和10%(2例),治療48 w 患者 ETVR、SVR 和複髮分彆為95%(19例)、90%(18例)和5.3%(1例),兩組比較無統計學差異(P>0.05);在40例患者,基線 HCV RNA 水平與 SVR 呈負相關(OR=0.422,95%CI 為0.05~0.29,P=0.007);在治療36 w 患者,基線 HCV RNA<6×107IU/ml 患者 SVR 顯著高于 HCV RNA≥6×107IU/ml 患者(P=0.005),但在治療48 w 患者,未髮現這種差異(P=0.063)。結論對于基線 HCV RNA 水平>400000 IU/ml 的基因1型慢性丙型肝炎初治患者,接受聚乙二醇榦擾素α-2a 聯閤利巴韋林治療,如在2 w 時穫得病毒學應答,治療36 w 療程與48 w 療程的 SVR 相噹。
목적:관찰획득겁쾌속병독학응답적초치기인1형만성병형간염환자,재계속접수36 w 취을이순간우소α-2a 연합리파위림치료후적료효。방법장기선 HCV RNA 수평>400000 IU/ml、접수취을이순간우소α-2a(180μg/w)연합리파위림(1000~1200 mg/d)치료2 w 후 HCV RNA 음전적기인1형만성병형간염초치환자,수궤분위량조,분별접수36 w 화48 w 치료,재정약후수방24 w,관찰료효。결과본연구공납입40례환자,량조각20례。치료36 w 환자재치료결속시병독학응답(ETVR)、지속병독학응답(SVR)화복발솔분별위100%(20례)、90%(18례)화10%(2례),치료48 w 환자 ETVR、SVR 화복발분별위95%(19례)、90%(18례)화5.3%(1례),량조비교무통계학차이(P>0.05);재40례환자,기선 HCV RNA 수평여 SVR 정부상관(OR=0.422,95%CI 위0.05~0.29,P=0.007);재치료36 w 환자,기선 HCV RNA<6×107IU/ml 환자 SVR 현저고우 HCV RNA≥6×107IU/ml 환자(P=0.005),단재치료48 w 환자,미발현저충차이(P=0.063)。결론대우기선 HCV RNA 수평>400000 IU/ml 적기인1형만성병형간염초치환자,접수취을이순간우소α-2a 연합리파위림치료,여재2 w 시획득병독학응답,치료36 w 료정여48 w 료정적 SVR 상당。
Objective To observe the extremely rapid virologic response (ERVR) in naive patient with chronic hepatitis C with genotype 1 virus infection receiving pegylated interferon and ribavirin treatment. Methods Forty naive hepatitis C patients with genotype 1 infection had baseline serum HCV RNA≥400000 IU/ml and they were treated with peginterferon-alpha-2a at dose of 180 μg per week and ribavirin at dose of 1000-1200 mg/d. After 2 week treatment,they all got so -called extremely rapid virologic response and then,they were randomly divided into two groups,e.g. 20 patients continued the regimen for 36 weeks (group 1) and another 20 patients received the therapy for 48 weeks (group 2). All patients were followed-up for 24 weeks after discontinuation. Results The end-of-treatment virologic response (ETVR),sustained virologic response(SVR) and recurrence rate of patients in group one were 100%,90% and 10%,respectively,while they were 95%,90% and 5.3% in group 2. There was no statistical differences between the two groups;There was a negative correlation between baseline serum HCV RNA levels and SVR(OR=0.422,95%CI 0.05-0.29,P=0.007)in the 40 patients;The SVR in patients with baseline serum HCV RNA﹤6×107IU/ml was higher than that in patients with baseline serum HCV RNA≥6× 107IU/ml in group 1 (P=0.005),but not in group 2 (P=0.063). Conclusions The ERVR in naive patients with chronic hepatitis C receiving peginterferon -alpha -2a plus ribavirin treatment suggests relatively less anti -viral regimen and the same efficacy.