CAJ | 학술논문

目的：探讨聚乙二醇干扰素α-2a 联合利巴韦林对丙型肝炎抗病毒治疗的远期疗效与安全性分析。方法选取2004年2月至2006年10月126例经抗病毒治疗的丙型肝炎患者作为治疗组，另选取45例未进行抗病毒治疗的丙型肝炎患者作为对照组，比较两组患者的病毒学应答效果，累积随访8年内患者的远期疗效，进行安全性评价。结果治疗组患者获得 cRVR 39例（31．0％）、qRVR 74例（58．7％）。对照组患者获得 cRVR 为6例（13．3％）、qRVR 4例（8．9％）；在EVR 方面，治疗组在 cEVR 方面与对照组差异有非常显著性意义（P ＜0．01）；治疗组患者获得 ETVR 106例（84．1％）、SVR 87例（69．0％），对照组 ETVR 为10例（22．2％）、SVR 为1例（2．2％）差异有非常显著性意义（P ＜0．01）；累积随访达8年左右，发现未持续病毒学应答组患者在肝功能异常（74．36％）、全因病死率（23．08％）、HCV RNA 阳性率（79．49％）、肝因性病死率（23．08％）、肝纤维化比例（23．08％）、肝硬化比例（20．51％）以及肝癌发生率（12．51％）均与持续病毒学应答组（分别为9．20％、8．05％、13．79％、2．39％、3．48％、2．39％、2．39％）、对照组（分别为95．56％、26．67％、95．56％、26．67％、28．89％、15．56％、24．44％）差异有统计学意义（P ＜0．01）；未持续病毒学应答组与持续病毒学应答组各方面在血液流变学异常方面差异有统计学意义（P ＜0．05）。结论聚乙二醇干扰素联合利巴韦林治疗丙型肝炎患者获得持续病毒学应答效果明显增高，其远期疗效明显，且持续病毒学应答患者在全因性死亡率、肝因性死亡、肝硬化死亡率以及肝癌发生率等方面均低于非持续病毒学应答患者。
목적：탐토취을이순간우소α-2a 연합리파위림대병형간염항병독치료적원기료효여안전성분석。방법선취2004년2월지2006년10월126례경항병독치료적병형간염환자작위치료조，령선취45례미진행항병독치료적병형간염환자작위대조조，비교량조환자적병독학응답효과，루적수방8년내환자적원기료효，진행안전성평개。결과치료조환자획득 cRVR 39례（31．0％）、qRVR 74례（58．7％）。대조조환자획득 cRVR 위6례（13．3％）、qRVR 4례（8．9％）；재EVR 방면，치료조재 cEVR 방면여대조조차이유비상현저성의의（P ＜0．01）；치료조환자획득 ETVR 106례（84．1％）、SVR 87례（69．0％），대조조 ETVR 위10례（22．2％）、SVR 위1례（2．2％）차이유비상현저성의의（P ＜0．01）；루적수방체8년좌우，발현미지속병독학응답조환자재간공능이상（74．36％）、전인병사솔（23．08％）、HCV RNA 양성솔（79．49％）、간인성병사솔（23．08％）、간섬유화비례（23．08％）、간경화비례（20．51％）이급간암발생솔（12．51％）균여지속병독학응답조（분별위9．20％、8．05％、13．79％、2．39％、3．48％、2．39％、2．39％）、대조조（분별위95．56％、26．67％、95．56％、26．67％、28．89％、15．56％、24．44％）차이유통계학의의（P ＜0．01）；미지속병독학응답조여지속병독학응답조각방면재혈액류변학이상방면차이유통계학의의（P ＜0．05）。결론취을이순간우소연합리파위림치료병형간염환자획득지속병독학응답효과명현증고，기원기료효명현，차지속병독학응답환자재전인성사망솔、간인성사망、간경화사망솔이급간암발생솔등방면균저우비지속병독학응답환자。
Objective To investigate the long-term efficacy and safety of pegylated interferon α-2a plus ribavirin for hepatitis C antiviral therapy.Methods For virological response analysis,126 patients of hepatitis C,who had received antiviral therapy in our hospital from February 2004 to October 2006,were enrolled as treatment group,and another untreated 45 cases with hepatitis C were set as control group.An 8-year follow-up for long-term efficacy analysis and safety evaluation was carried out among those patients.Results There were significant differences in rapid virological response (RVR),including complete RVR and partial RVR (P <0.05 and P <0.01)between treatment group and control group.In addition,there were also significant differences in complete early virological response (cEVR),end of treatment virus response (EOT)and sustained virological response (SVR)[6(13.3%)vs.4(8.9%),106(84.1 %)vs.10(22.2%)and 87 (69.0%)vs.1(2.2%),respectively,(P <0.01)]between the two groups.During the cumulative follow-up for 8 years, abnormal liver function (74.36%),all-cause mortality (23.08%),positive rate of hepatitis C virus RNA (79.49%), mortality due to liver disease (23.08%),hepatic fibrosis rate (23.08%),liver cirrhosis rate (20.51 %),and liver cancer morbidity (12.51 %)were computed in non-SVR group,which were statistically different (P <0.01 )from those in SVR group (9.20%,8.05%,13.79%,2.39%,3.48%,2.39% and 2.39%,respectively)and control group (95.56%, 26.67%,95.56%,26.67%,28.89%,15.56% and 24.44%,respectively).Meanwhile,abnormal blood rheology in non-SVR group was statistically different (P <0.05)from that in SVR group.Conclusion Combination of pegylated interferon and ribavirin for hepatitis C not only induced significantly efficient SVR but also sustained obvious long-term effect. Additionally,patients with SVR had lower all-cause mortality,mortality due to liver disease,incidence of cirrhosis compared with non-SVR patients.