CAJ | 학술논문

目的分析聚乙二醇干扰素α-2a (Peg-IFN α-2a)与IFN α-2a治疗慢性丙型肝炎的疗效. 方法采用回顾性队列研究方法,收集2010至2012年初次接受IFN抗病毒治疗的HCV患者188例,其中Peg-IFN α-2a组55例,IFNα-2a组133例,比较治疗前、治疗4、12、24、48周时两组HCV载量、ALT、AST之间的差异及不良反应发生情况.结果初始治疗前两组性别、年龄、吸烟、饮酒、HCV基因分型、HCV载量、肝功能等比较,P值均＞0.05,差异无统计学意义.Peg-IFNα-2a组和IFNα-2a组患者,抗病毒治疗前HCV载量、ALT、AST值均高于治疗4、12、24、48周时HCV载量,P值均＜0.05,差异有统计学意义.Peg-IFN α-2a组治疗4周时HCV载量为(2.96±0.66) log10 IU/ml,低于IFNα-2a组的(3.47±1.42) log10 IU/ml,两组比较,F=4.14,P＜0.05,差异有统计学意义;Peg-IFN α-2a组快速病毒学应答率为72.72％,高于IFNα-2a组的57.14％,两组比较,x2=4.37,P=0.04,差异有统计学意义;两组生物化学应答率、早期病毒学应答率、治疗结束时病毒学应答率及抗病毒治疗不良反应发生率比较,值均＞0.05,差异无统计学意义.结论 Peg-IFNα-2a组初治慢性丙型肝炎快速病毒学应答率高于IFN α-2a组,但生物化学应答率、早期及治疗结束时病毒学应答率及不良反应发生率与IFNα-2a组比较,差异无统计学意义,远期疗效差异仍需进一步随访观察.
목적 분석취을이순간우소α-2a (Peg-IFN α-2a)여IFN α-2a치료만성병형간염적료효. 방법 채용회고성대렬연구방법,수집2010지2012년초차접수IFN항병독치료적HCV환자188례,기중Peg-IFN α-2a조55례,IFNα-2a조133례,비교치료전、치료4、12、24、48주시량조HCV재량、ALT、AST지간적차이급불량반응발생정황.결과 초시치료전량조성별、년령、흡연、음주、HCV기인분형、HCV재량、간공능등비교,P치균＞0.05,차이무통계학의의.Peg-IFNα-2a조화IFNα-2a조환자,항병독치료전HCV재량、ALT、AST치균고우치료4、12、24、48주시HCV재량,P치균＜0.05,차이유통계학의의.Peg-IFN α-2a조치료4주시HCV재량위(2.96±0.66) log10 IU/ml,저우IFNα-2a조적(3.47±1.42) log10 IU/ml,량조비교,F=4.14,P＜0.05,차이유통계학의의;Peg-IFN α-2a조쾌속병독학응답솔위72.72％,고우IFNα-2a조적57.14％,량조비교,x2=4.37,P=0.04,차이유통계학의의;량조생물화학응답솔、조기병독학응답솔、치료결속시병독학응답솔급항병독치료불량반응발생솔비교,치균＞0.05,차이무통계학의의.결론 Peg-IFNα-2a조초치만성병형간염쾌속병독학응답솔고우IFN α-2a조,단생물화학응답솔、조기급치료결속시병독학응답솔급불량반응발생솔여IFNα-2a조비교,차이무통계학의의,원기료효차이잉수진일보수방관찰.
Objective To perform a retrospective cohort study in order to determine the differences in short-term curative effect of ribavirin in combination with interferon alfa (IFNα)-2a vs.pegylated (Peg)-IFNα-2a in patients with chronic hepatitis C (CHC).Methods One-hundred-and-eighty-eight treatmentna（i）ve CHC patients who were administered combination therapy of ribavirin with IFNα from 2010 to 2012.One-hundred-and-thirty-three of the patients received the therapy with IFNα-2a and the remaining 55 received Peg-IFNα-2a.Hepatitis C virus (HCV) load and levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured at treatment weeks 4,12,24,and 48.Adverse reactions were recorded.Differences between the groups were assessed by statistical analysis.Results The patients in the Peg-IFNα-2a group and the IFNα-2a group showed no significant difference in sex distribution,age,smoking habits,or drinking habits at baseline (all P ＞ 0.05).Both antiviral therapies significantly reduced the HCV load and levels of ALT and AST (baseline levels vs.all treatment weeks examined,P ＜ 0.05); however,the reduction in the HCV load at week 4 was significantly more robust with the Peg-IFNα-2a therapy ((2.96 ± 0.66) log10 IU/ ml vs.(3.47 ± 1.42)1og10 IU/ml; F =4.14,P =0.04).The Peg-IFNα-2a group also showed a significant higher rate of rapid virological response (RVR) than the IFNα-2a group (72.72％ vs.57.14％;x2 =4.37,P =0.04),but there were no statistically significant differences found between the two groups for early virological response rate (EVR),endpoint antiviral treatment virologic response rate (ETR),biochemical response rate,or rate of adverse reactions (all P ＞ 0.05).Conclusion Ribavirin in combination with Peg-IFNα-2a produces a better RVR than in combination with IFNα-2a.Yet,the EVR,ETR,biochemical response rate,and rate of adverse reactions is similar for the two forms of IFNα-2a,Further studies are required to determine the potential superiority of Peg-IFNα-2a for a long-term curative effect.