CAJ | 학술논문

目的探讨聚乙二醇干扰素α-2b联合利巴韦林治疗肾移植后丙型肝炎的疗效及安全性.方法对9例肾移植术后1年以上、合并丙型肝炎、血肌酐稳定在正常范围的受者,采用聚乙二醇干扰素α-2b(50 μg皮下注射,每周1次)联合利巴韦林(400～600mg/d口服)治疗.每月检测丙型肝炎病毒(HCV) RNA,HCV RNA转阴后继续巩固治疗3～9个月.观测病毒学应答情况,同时观察肝肾功能、血常规变化及治疗过程中的不良反应.结果 9例受者的总疗程为4～20个月,其中6例(66.7％)获得满意的持续病毒学应答(完全应答),随访至停用干扰素治疗后6个月未出现复发;2例在获得快速病毒学应答后,于巩固治疗3个月停止治疗后复发;1例在治疗8个月的过程中未见明显病毒学应答.治疗中所有受者的血肌酐水平均在正常范围内波动,所有受者均未出现急性排斥反应迹象.治疗过程中的主要不良反应包括流感样症候群(发热、肌肉酸痛、食欲不振等)、一过性骨髓抑制以及贫血等.所有不良反应未经处理或经对症处理后均可缓解或耐受.结论聚乙二醇干扰素α-2b联合利巴韦林治疗肾移植后合并丙型肝炎的移植肾功能稳定受者有确切疗效,对移植肾功能无明显影响,无严重不良反应,较为安全.
목적 탐토취을이순간우소α-2b연합리파위림치료신이식후병형간염적료효급안전성.방법 대9례신이식술후1년이상、합병병형간염、혈기항은정재정상범위적수자,채용취을이순간우소α-2b(50 μg피하주사,매주1차)연합리파위림(400～600mg/d구복)치료.매월검측병형간염병독(HCV) RNA,HCV RNA전음후계속공고치료3～9개월.관측병독학응답정황,동시관찰간신공능、혈상규변화급치료과정중적불량반응.결과 9례수자적총료정위4～20개월,기중6례(66.7％)획득만의적지속병독학응답(완전응답),수방지정용간우소치료후6개월미출현복발;2례재획득쾌속병독학응답후,우공고치료3개월정지치료후복발;1례재치료8개월적과정중미견명현병독학응답.치료중소유수자적혈기항수평균재정상범위내파동,소유수자균미출현급성배척반응적상.치료과정중적주요불량반응포괄류감양증후군(발열、기육산통、식욕불진등)、일과성골수억제이급빈혈등.소유불량반응미경처리혹경대증처리후균가완해혹내수.결론 취을이순간우소α-2b연합리파위림치료신이식후합병병형간염적이식신공능은정수자유학절료효,대이식신공능무명현영향,무엄중불량반응,교위안전.
Objective To investigate the safety and efficacy of pegylated interferon (PEG-IFN) and ribavirin for chronic hepatitis C following renal transplantation.Method Nine adult renal transplant recipients of ＞ 12-month duration,infected with hepatitis C virus (HCV),and with stable renal graft function were recruited.All patients were administered with PEG-IFN-α 2b 50 μg/week,plus ribovirin 400-600 mg/day.HCV viral load was reexamined monthly.Consolidation therapy lasted for 3-9 months after initial remission of HCV-RNA.Viral response,adverse effects and changes in hemogram,alanine aminotransferase and andserum creatinine were also monitored.Result The duration of treatment for 9 patients was 4-20 months.Sustained virologic response (SVR) occurred in 6 patients with no relapse during 6-month follow up period after the ceasation of the treatment.Two patients,with rapid virologic response,had a virologic relapse after completing their 3-month consolidation therapy.One patient maintained no obvious virologic response during 8 months of treatment.Renal function was kept in normal range in all patients and no one experienced a rejection episode during or after PEG-IFN-α 2b therapy.The major adverse reactions included influenza-like syndrome (fever,muscle soreness,anorexia),transient bone marrow suppression and anemia.All of the adverse reactions were transient and tolerable,and no discontinuation of PEG-IFN-a 2b therapy was required in all these patients.Conclusion For renal transplant recipients with stable renal graft function,treatment with PEG-IFN-α 2b and ribavirin has high efficacy in the treatment of HCV and is not associated with high risk of acute rejection of renal allografts.