CAJ | 학술논문

目的：观察聚乙二醇干扰素α－2a（PEg － IFN α－2a）联合利巴韦林（RBV）治疗中青年慢性丙型肝炎（CHC）患者和老年 CHC 患者的疗效与安全性。方法选择2008年1月至2012年6月收治的73例成年 CHC 患者，分为中青年组18~50岁和老年组（60岁以上）。所有患者均给予 PEg － IFN α－2a 注射液180μg、每周1次，同时口服 RBV 片300~400 mg /次、3次/日，均用药48周。观察患者的病毒学应答、肝功能、免疫功能及不良反应发生情况。结果两组患者治疗48周后，持续病毒性应答率（SVR）、丙氨酸氨基转移酶（ALT）、天门冬酸氨基转移酶（AST）、CD3+，CD4+，CD8+，CD4+/ CD8+、自然杀伤细胞(NK)等比较均无统计学差异（ P >0.05）。但老年组患者在白细胞下降、抑郁或焦虑、腹胀、心电图异常等4项不良反应的发生率显著高于中青年组（ P <0.05）。结论 PEg － IFN α－2a 和 RBV 联用治疗老年 CHC 有效，但必须重视不良反应。
목적：관찰취을이순간우소α－2a（PEg － IFN α－2a）연합리파위림（RBV）치료중청년만성병형간염（CHC）환자화노년 CHC 환자적료효여안전성。방법선택2008년1월지2012년6월수치적73례성년 CHC 환자，분위중청년조18~50세화노년조（60세이상）。소유환자균급여 PEg － IFN α－2a 주사액180μg、매주1차，동시구복 RBV 편300~400 mg /차、3차/일，균용약48주。관찰환자적병독학응답、간공능、면역공능급불량반응발생정황。결과량조환자치료48주후，지속병독성응답솔（SVR）、병안산안기전이매（ALT）、천문동산안기전이매（AST）、CD3+，CD4+，CD8+，CD4+/ CD8+、자연살상세포(NK)등비교균무통계학차이（ P >0.05）。단노년조환자재백세포하강、억욱혹초필、복창、심전도이상등4항불량반응적발생솔현저고우중청년조（ P <0.05）。결론 PEg － IFN α－2a 화 RBV 련용치료노년 CHC 유효，단필수중시불량반응。
Objective To compare the efficacy and safety of peginterferon α - 2a(PEg - IFN α - 2a) combined with ribavirin(RBV) in the treatment of young and middle - aged patients with chronic hepatitis C(CHC) and elderly patients with CHC. Methods 73 adults inpatients with CHC in our hospital from January 2008 to June 2012 were selected as the research subjects and divided into the young and middle aged group (18 - 50 years old) and the elderly group( ≥ 60 years old) according to their age. All patients were given PEg - IFN α - 2a injection 180μg, once per week and simultaneously took oral RBV tablets 300 - 400 mg, 3 times daily for 48 weeks. The virological response, liver function, immune function and adverse reactions were observed in the two groups. Results After 48 - week treatment, there was no significant difference in sustained virological response(SVR), ALT, AST, CD3 +, CD4 +, CD8 +, CD4 + / CD8 +and NK cell between the young and middle aged group and the elderly group( P > 0. 05 ). But the occurrence rates of some adverse re-actions in the elderly group were higher than those in the young and middle aged group, including leukocytopenia, depression or anXiety, abdominal distension and electrocardiographic abnormality( P < 0. 05) . Conclusion The combination use of PEg - IFN α - 2a and RBV is effective in the treatment of elderly CHC. However, the adverse reactions should be paid attention to.