聚乙二醇干扰素α-2a注射液联合利巴韦林片治疗脾栓塞术后丙型病毒性肝炎肝硬化的临床研究

发布时间：2018-01-19 16:15

本文关键词： 聚乙二醇干扰素α-a 利巴韦林丙型肝炎　出处：《中国临床药理学杂志》2017年16期 　论文类型：期刊论文

【摘要】：目的观察聚乙二醇干扰素α-2a注射液联合利巴韦林治疗脾栓塞术后丙型病毒性肝炎(HCV,丙肝)肝硬化患者的临床疗效和安全性。方法将64例脾栓塞术后丙肝肝硬化患者随机分为对照组32例和试验组32例。2组患者均给予口服利巴韦林片,每次300 mg,tid的治疗。对照组给予皮下注射重组人干扰素α-2b的方式,每次3 MU,隔日注射;试验组在对照组治疗的基础上,给予皮下注射聚乙二醇干扰素α-2a,每次180μg,每周1次。2组患者连续治疗12周。比较2组患者治疗前后HCV RNA阳性率、血常规相关参数,血清谷丙转氨酶(ALT)、谷草转氨酶(AST)水平变化,以及药物不良反应的发生情况。结果治疗前2组患者HCV RNA阳性率均为100%(32/32例),治疗后,试验组和对照组HCV RNA阳性率分别为53.13%(17/32例)和78.12%(25/32例),差异有统计学意义(P0.05)。治疗后,试验组和对照组的ANC分别为(4.76±0.33)×10~9,(3.92±0.17)×10~9/L;PLT水平分别为(142.73±17.04)×10~9,(128.72±17.96)×10~9/L;WBC水平分别为(8.15±1.84)×10~9,(6.57±1.69)×10~9/L;ALT水平分别为(41.25±22.42),(60.12±21.89)U·L~(-1);AST水平分别为(33.67±18.46),(51.22±16.95)U·L~(-1);AST/ALT值分别为0.78±0.69,1.27±0.73,差异均有统计学意义(均P0.05)。试验组的药物不良反应发生率为40.63%(13/32例),对照组发生的药物不良反应发生率为28.12%(9/32例),差异无统计学意义(P0.05)。结论聚乙二醇干扰素α-2a联合利巴韦林治疗脾栓塞术后丙肝肝硬化患者可有效降低患者HCV RNA阳性率,改善患者体内血清AST、ALT水平,安全性高。
[Abstract]:Objective to observe the efficacy of polyethylene glycol interferon 伪 -2a injection combined with ribavirin in the treatment of hepatitis C virus hepatitis C after splenic embolization. Methods 64 patients with liver C cirrhosis after splenic embolization were randomly divided into control group (32 cases) and experimental group (32 cases) treated with ribavirin tablets. The control group was given subcutaneous injection of recombinant human interferon 伪 -2b, 3 MUU every other day. On the basis of the treatment in the control group, the experimental group was given subcutaneous injection of peginterferon 伪 -2a at 180 渭 g each time. The positive rate of HCV RNA, blood routine parameters and serum alanine aminotransferase (alt) were compared between the two groups before and after treatment. Results the positive rate of HCV RNA in the two groups before and after treatment was 100 / 32 / 32 cases. The positive rates of HCV RNA in the experimental group and the control group were 53.13 and 78.12 / 25 / 32, respectively. The difference was statistically significant (P 0.05). The ANC of the test group and the control group were 4.76 卤0.33 脳 10 ~ (9) C ~ (3) 卤0.92 卤0.17) 脳 10 ~ (9 / L) respectively. The PLT levels were 128.72 卤17.96 脳 10 ~ (9) / L, respectively, at 142.73 卤17.04 脳 10 ~ (-4) 脳 10 ~ (-9) / L; The WBC level was 8.15 卤1.84 脳 10 ~ (-9) 卤6.57 卤1.69) 脳 10 ~ (9) 路L ~ (-1) 路L ~ (-1); The levels of ALT were 41.25 卤22.42, 60.12 卤21.89 U 路L ~ (-1) U 路L ~ (-1), respectively. The AST levels were 33.67 卤18.46 U 路L ~ (-1), 51.22 卤16.95 U 路L ~ (-1), respectively. The AST/ALT values were 0.78 卤0.69 and 1.27 卤0.73, respectively. The difference was statistically significant (P 0.05). The incidence of adverse drug reactions in the trial group was 40.63% and 13 / 32 cases respectively). The incidence of adverse drug reactions in the control group was 28.12 / 9 / 32). Conclusion the combination of pegylated interferon 伪 -2a and ribavirin can effectively reduce the positive rate of HCV RNA in patients with cirrhosis of hepatitis C after splenic embolization. It is safe to improve the serum alt level in patients with AST.
【作者单位】：无锡市第五人民医院传染科;
【基金】：南京医科大学科技发展基金资助项目(2013NJMU195)
【分类号】：R512.63;R657.6
【正文快照】： (无锡市第五人民医院传染科,江苏无锡214005)DU He-juan,JIANG Yi-ming,YANG Qi-en,CHEN Ren-fang,LU Yu-hong,CHEN Miao,ZHOU Xue-shi,CAO Hong(Department of Infection,Wuxi No.5People’s Hospital,Wuxi 214005,JiangsuProvince,China)丙型病毒性肝炎(丙肝)是一种由丙型肝

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