临床肝胆病杂志
臨床肝膽病雜誌
림상간담병잡지
CHINESE JOURNAL OF CLINICAL HEPATOLOGY
2015年
4期
560-563
,共4页
肝炎,丙型,慢性%基因型%复发%干扰素α%利巴韦林
肝炎,丙型,慢性%基因型%複髮%榦擾素α%利巴韋林
간염,병형,만성%기인형%복발%간우소α%리파위림
hepatitis C,chronic%genotype%recurrence%interferon-alpha%ribavirin
目的：探讨基因1型慢性丙型肝炎（CHC）慢应答患者复发与疗程的相关性。方法收集2010年4月－2013年3月焦作市第三人民医院、焦作市人民医院住院或门诊的基因1型CHC患者157例，采用干扰素α－1b联合利巴韦林治疗，其中51例获得慢应答患者在治疗6个月时随机分为A（24例）、B（27例）两组，分别继续原方案治疗6、12个月，停药后随访1年。观察不良反应对抗病毒治疗方案的影响，比较两组治疗结束时HCV RNA阴转率、ALT复常率，停药后6个月、1年的复发率及ALT复常率。计量资料组间比较采用t检验，计数资料组间比较采用χ2检验。结果治疗中两组患者不良反应的发生率比较，差异均无统计学意义（P值均＞0．05）。治疗结束时两组患者HCV RNA阴转率（95．65％ vs 92．59％）、ALT复常率（95．65％ vs 88．89％）比较差异均无统计学意义（χ2值分别为0．02、0．13，P值均＞0．05）。停药6个月、1年后，B组患者复发率均显著低于A组（20．00％ vs 50．00％；36．00％ vs 68．18％），差异具有统计学意义（χ2值分别为4．69、4．85，P值均＜0．05）；停药6个月、1年后，B组患者ALT复常率均高于A组（84．00％ vs 59．09％；72．00％ vs 50．00％），但差异均无统计学意义（χ2值分别为3．63、2．40，P值均＞0．05）。结论 基因1 型CHC 慢应答患者延长疗程6 个月可明显减少复发。
目的：探討基因1型慢性丙型肝炎（CHC）慢應答患者複髮與療程的相關性。方法收集2010年4月－2013年3月焦作市第三人民醫院、焦作市人民醫院住院或門診的基因1型CHC患者157例，採用榦擾素α－1b聯閤利巴韋林治療，其中51例穫得慢應答患者在治療6箇月時隨機分為A（24例）、B（27例）兩組，分彆繼續原方案治療6、12箇月，停藥後隨訪1年。觀察不良反應對抗病毒治療方案的影響，比較兩組治療結束時HCV RNA陰轉率、ALT複常率，停藥後6箇月、1年的複髮率及ALT複常率。計量資料組間比較採用t檢驗，計數資料組間比較採用χ2檢驗。結果治療中兩組患者不良反應的髮生率比較，差異均無統計學意義（P值均＞0．05）。治療結束時兩組患者HCV RNA陰轉率（95．65％ vs 92．59％）、ALT複常率（95．65％ vs 88．89％）比較差異均無統計學意義（χ2值分彆為0．02、0．13，P值均＞0．05）。停藥6箇月、1年後，B組患者複髮率均顯著低于A組（20．00％ vs 50．00％；36．00％ vs 68．18％），差異具有統計學意義（χ2值分彆為4．69、4．85，P值均＜0．05）；停藥6箇月、1年後，B組患者ALT複常率均高于A組（84．00％ vs 59．09％；72．00％ vs 50．00％），但差異均無統計學意義（χ2值分彆為3．63、2．40，P值均＞0．05）。結論 基因1 型CHC 慢應答患者延長療程6 箇月可明顯減少複髮。
목적：탐토기인1형만성병형간염（CHC）만응답환자복발여료정적상관성。방법수집2010년4월－2013년3월초작시제삼인민의원、초작시인민의원주원혹문진적기인1형CHC환자157례，채용간우소α－1b연합리파위림치료，기중51례획득만응답환자재치료6개월시수궤분위A（24례）、B（27례）량조，분별계속원방안치료6、12개월，정약후수방1년。관찰불량반응대항병독치료방안적영향，비교량조치료결속시HCV RNA음전솔、ALT복상솔，정약후6개월、1년적복발솔급ALT복상솔。계량자료조간비교채용t검험，계수자료조간비교채용χ2검험。결과치료중량조환자불량반응적발생솔비교，차이균무통계학의의（P치균＞0．05）。치료결속시량조환자HCV RNA음전솔（95．65％ vs 92．59％）、ALT복상솔（95．65％ vs 88．89％）비교차이균무통계학의의（χ2치분별위0．02、0．13，P치균＞0．05）。정약6개월、1년후，B조환자복발솔균현저저우A조（20．00％ vs 50．00％；36．00％ vs 68．18％），차이구유통계학의의（χ2치분별위4．69、4．85，P치균＜0．05）；정약6개월、1년후，B조환자ALT복상솔균고우A조（84．00％ vs 59．09％；72．00％ vs 50．00％），단차이균무통계학의의（χ2치분별위3．63、2．40，P치균＞0．05）。결론 기인1 형CHC 만응답환자연장료정6 개월가명현감소복발。
Objective To investigate the relevance between relapse and course of treatment in genotype 1 chronic hepatitis C (CHC)pa-tients with slow virologic response.Methods Totally 157 genotype 1 CHC inpatients or outpatients were selected from the Third People′s Hospital of Jiaozuo and the People′s Hospital of Jiaozuo from April 2010 to March 2013.The patients were treated with interferon α-1b in conjunction with ribavirin.At 6 months of the initial treatment,5 1 patients with slow virologic response were randomly divided into groups A (24 cases)and B (27 cases),which received continued treatment for another 6 and 12 months,respectively.A 1 -year follow-up of pa-tients was performed after withdrawal of treatment.Adverse reactions in patients receiving the antiviral therapy were assessed.Furthermore, group comparisons were performed on the clearance rate of hepatitis C virus (HCV)RNA and normalization rate of alanine aminotransferase (ALT)at withdrawal of treatment,as well as the CHC relapse rate and ALT normalization rate at 6 months and 1 year after withdrawal of treatment.Continuous data were compared using t test,and categorical data were compared usingχ2 test.Results The rate of adverse reac-tions in patients receiving antiviral therapy had no significant difference between groups A and B (P>0.05 ).At withdrawal of treatment, there were no significant differences between groups in terms of HCV RNA clearance rate (95.65%vs 92.59%)and ALT normalization rate (95.65% vs 88.89%)(χ2 =0.02 and 0.13,respectively,both P>0.05).At 6 months and 1 year after withdrawal of treatment,the CHC relapse rate in group B was significantly lower than that in group A (20.00% vs 50.00%,χ2 =4.69,P <0.05;36.00% vs 68.18%,χ2 =4.85,P<0.05);the ALT normalization rate in group B was nonsignificantly higher than that in group A (84.00% vs 59.09%,χ2 =3.63,P>0.05;72.00% vs 50.00%,χ2 =2.40,P>0.05).Conclusion To extend the 6 -month course of treatment can significantly reduce the relapse following slow virologic response in patients with genotype 1 CHC.
