CAJ | 학술논문

目的：观察聚乙二醇干扰素α－2b（pegylated interferon α－2b，Peg－IFNα－2b）分层方法治疗白细胞（WBC）减少慢性丙型肝炎（CHC）的临床疗效。方法：将入组的105例患者分为3组，均使用保肝降酶药物，A 组患者初始加用 Peg－IFNα－2b，50μg，1次／周，B 组患者初始加用普通干扰素α（IFN－α）1MU／次，1次／隔日，均皮下注射。两组患者均同时口服利巴韦林300mg／次，3次／d。根据患者反应，逐渐加大 IFN 剂量，密切监测血常规及不良反应，必要时采用辅助升白细胞药物。最后 Peg－IFNα－2b 达到80μg／次，1次／周， IFN α达到3MU／次，1次／隔日。 C 组患者仅使用保肝降酶药物。疗程1年。结果：在治疗1年时 A、B、C 3组患者组 ALT分别为（34±22）U／L、（67±44）U／L、（154±58）U／L，AST 分别为（40±12）U／L、（79±32）U／L、（139±86）U／L ；透明质酸（HA）分别为（48．13±30．21）μg／L 、（89．34±76．42）μg／L、（201．34±106．21）μg／L，层粘蛋白（LN）分别为（102．1±79．52）μg／L 、（239±87．54）μg／L、（536．68±358．35）μg／L，A、B 组显著低于 C 组（P ＜0．05），A 组显著低于 B 组（P ＜0．05）；腹水出现率分别为0、0、10％；门静脉宽≥1．3cm 比率分别为0、3．85％、10％；脾厚＞4cm 比率分别为4．34％、7．69％、16．67％，A、B 组显著低于 C 组（P ＜0．05），A组显著低于 B 组（P ＜0．05）；丙型肝炎病毒核糖核酸（HCV RNA）＜1000IU／ml 比率分别为91．30％、59．61％、0；WBC ＞3．0×109／L比率分别为91．30％、59．61％、0，A、B 组显著高于 C 组（P ＜0．05），A 组显著高于 B 组（P ＜0．05）。结论：白细胞减少的 CHC 患者可予干扰素抗病毒治疗。
목적：관찰취을이순간우소α－2b（pegylated interferon α－2b，Peg－IFNα－2b）분층방법치료백세포（WBC）감소만성병형간염（CHC）적림상료효。방법：장입조적105례환자분위3조，균사용보간강매약물，A 조환자초시가용 Peg－IFNα－2b，50μg，1차／주，B 조환자초시가용보통간우소α（IFN－α）1MU／차，1차／격일，균피하주사。량조환자균동시구복리파위림300mg／차，3차／d。근거환자반응，축점가대 IFN 제량，밀절감측혈상규급불량반응，필요시채용보조승백세포약물。최후 Peg－IFNα－2b 체도80μg／차，1차／주， IFN α체도3MU／차，1차／격일。 C 조환자부사용보간강매약물。료정1년。결과：재치료1년시 A、B、C 3조환자조 ALT분별위（34±22）U／L、（67±44）U／L、（154±58）U／L，AST 분별위（40±12）U／L、（79±32）U／L、（139±86）U／L ；투명질산（HA）분별위（48．13±30．21）μg／L 、（89．34±76．42）μg／L、（201．34±106．21）μg／L，층점단백（LN）분별위（102．1±79．52）μg／L 、（239±87．54）μg／L、（536．68±358．35）μg／L，A、B 조현저저우 C 조（P ＜0．05），A 조현저저우 B 조（P ＜0．05）；복수출현솔분별위0、0、10％；문정맥관≥1．3cm 비솔분별위0、3．85％、10％；비후＞4cm 비솔분별위4．34％、7．69％、16．67％，A、B 조현저저우 C 조（P ＜0．05），A조현저저우 B 조（P ＜0．05）；병형간염병독핵당핵산（HCV RNA）＜1000IU／ml 비솔분별위91．30％、59．61％、0；WBC ＞3．0×109／L비솔분별위91．30％、59．61％、0，A、B 조현저고우 C 조（P ＜0．05），A 조현저고우 B 조（P ＜0．05）。결론：백세포감소적 CHC 환자가여간우소항병독치료。
Objective:To investigate the clinical efficacy of pegylated interferon a-2b (Peg-IFNα-2b) treatment of white blood cells less than 3.0X10 9 /L repeatedly elevated transaminase in patients with chronic hepatitis C.Methods:105 patients were divided into three groups, three groups of patients the use of protecting liver and reducing enzyme drugs.Group A with initial plus PEG-interferon α-2b(Peg-IFNα-2b) 50 μg once a week,group B with IFN-αplus the initial 1MU, 1 every other day, subcutaneous injection of started applications.The two groups were using the Ribavirin 900mg/day application.Based on the reaction of patients, the dose increase gradually, close monitoring of blood routine,and other adverse reactions, increasing leukocyte drug assistance when necessary.Finally Peg-IFNα-2b reached 80μg once a week, IFN-αto 3MU 1 every other day, subcutaneous injection.Observation of 1 years. Result:In the 1 year treatment A, B, C group in glutamic-pyruvic transaminase( ALT )were (34 ±22) U/L, (67 ±44) U/L, (154 ±58) U/L.Glutamic-oxalacetic transaminase( AST ) were (40 ±12) U/L, (79 ±32) U/L, (139 ±86) U/L.Hyaluronic acid(HA) respectively (48.13 ±30.21) μg/L, (89.34 ±76. 42) μg/L, (201.34 ±106.21) μg/L.Laminin (LN )were (102.1 ±79.52) μg/L, (239 ±87.54) μg/L, (536.68 ±358.35) μg/L. Group A and B Were significantly lower than that of group C(P <0.05), group A was significantly lower than that of group B(P <0.05). The ascites proportion were 0, 0, 10%.Portal vein width≥1.3cm ratio were 0、3.85%、10%.Ratio of spleen thickness >4cm were 4. 34%,7.69%,16.67%.Group A and B were significantly lower than that of group C(P <0.05), group A was significantly lower than that of group B(P <0.05).Ratio of hepatitis C virus ribonucleic acid (HCV RNA) <1000IU/ml were 91.30%,59.61%,0 and the proportion of white blood cell ( WBC) >3.0 ×10 9 /L were 91.30%,59.61%,0.Group A and B were significantly higher than that of group C(P <0.05), group A was significantly higher than that of group B(P <0.05).Conclusion:White blood cells reduce patients with chronic hepatitis C can be treated by IFN-αantiviral therapy.