热带病与寄生虫学

热带病与寄生虫学 ›› 2015, Vol. 13 ›› Issue (3): 143-146.doi: 10.3969/j.issn.1672-2302.2015.03.006

• 论著 • 上一篇    下一篇

重组人干扰素α-2b治疗基因2、3型慢性丙型肝炎量效关系的观察

徐菁，吴莉娜   

  1. 061001  河北沧州市，沧州市传染病医院肝五科（徐菁），沧州市南湖社区卫生服务中心消化科（吴莉娜）
  • 出版日期:2015-09-10 发布日期:2015-09-30

Observation on the therapy response in patients with chronic hepatitis C with genotype 2/3 to recombinant human interferon α-2b

Xu Jing1, Wu lina   

  1. 1. No. 5 Department, Cangzhou Hospital for Infectious Diseases, Cangzhou, 061001, China. 2.  Sounth Lake Community Healthy Care Center of Cangzhou City, Cangzhou 061001, China.
  • Online:2015-09-10 Published:2015-09-30

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摘要： 菁    吴莉娜 【摘要】 目的  观察不同剂量重组人干扰素（IFN） α-2b联合利巴韦林（RBV）治疗基因2、3型慢性丙型肝炎的临床疗效。 方法  2010年1月~2013年5月到我院肝病科治疗的基因2、3型CHC患者122例分为治疗组62例和对照组60例，两组均在前12周隔日皮下注射重组人干扰素α2b注射液6 mU，治疗组在第13周隔日皮下注射重组人干扰素α2b注射液3mU；对照组在第13周仍隔日皮下注射重组人干扰素α2b注射液5mU；两组均每日分3次口服RBV 900~1 200mg，获得治疗结束时病毒学应答（ETVR）的患者在治疗结束后24周时随访；对无应答（NR）患者延长疗程3个月。2组均治疗48周，随访24周。比较两组治疗后快速病毒学应答（RVR）、早期病毒学应答（EVR）、治疗结束时病毒学应答（ETVR）、无应答（NR）和持久病毒学应答（SVR）情况；比较两组治疗药物费用和不良反应。 结果  治疗组和对照组获得RVR、EVR、ETVR均较高，分别为38例（61.2％）和35例（58.3％）（χ2=0.111，P＞0.05）；43例（69.4％）和40例（66.7％）（χ2=0.107，P＞0.05）；49例（79％）和51例（85％）（χ2=0.735，P＞0.05）。治疗组和对照组NR均较低，分别为9例（14.5％）和8例（13.3％）（χ2=0.0356，P＞0.05）。治疗组和对照组获得SVR也较高，分别为46例（74.2％）和47例（78.3％）（χ2=0.29，P＞0.05），差异均无统计学意义。治疗组使用IFNα-2b的总量及治疗药物费用比对照组少近30％，药物不良反应也较轻。 结论  IFNα-2b联合RBV治疗基因2、3型慢性丙型肝炎可获得较高的RVR、EVR，获得EVR后即12周后适当减少IFN剂量的维持治疗也能获得较高的ETVR和SVR，能减轻患者经济负担和药物不良反应。

关键词: 丙型肝炎, 慢性, 干扰素&alpha, 2b, 利巴韦林

Abstract:

【Abstract】 Objective  To observe the clinical efficacy of ribavirin (RBV) plus diverse dosage of recombinant human interferon alpha-2b (IFN α-2b) in chronic patients infected with hepatitis C virus(CHC) genotype 2/3. Methods  One hundred and twenty-two patients infected with CHC genotype 2/3, received therapy in our hospital from January 2010 through May 2013, were allocated to treatment group(n=62) and control group(n=60). Patients in the two groups were uniformly administered by subcutaneous injection of IFN α-2b in dose of 6mU, every other day in the first 12 weeks. By the 13th week, the treatment group received subcutaneous injection of IFN α-2b in dose of 3mU, whereas the control group were subcutaneously given IFN α-2b in dose of 5mU, every other day, in combination with oral RBV in dose of 900- 1200 mg, three time a day. Follow-up started at the 24th week after therapy in patients had achieved end-of-treatment virologic response (ETVR), and non-responders were given extended therapy course for 3 months. Totally, two groups of patients received therapy sessions of 48 weeks and follow-up of 24 weeks. Then the two groups were compared regarding the corresponding rapid virologic response rate(RVR), non-response (NR), sustained SVR, treatment cost and adverse response. Results RVR, EVR and ETVR were 61.2% (38/62) and 58.3%(35/60), 69.4%(43/62) and 66.7%(40/60), 79%(49/62) and 85%(51/60), (χ2= 0.111, P> 0.05 ), (χ2 = 0.107, P> 0.05 ), (χ2= 0.735, P>0.05), respectively. The treatment group had lower NR than the controls[14.%(9/62) vs. 13.3%(8/60), (χ2=0.0356, P>0.05)], yet higher SVR[74.2%(46/62)vs. 78.3%(47/60), (χ2=0.29, P> 0.05)]. In addition, the treatment group consumed lower dose of IFNα-2b, and had reduction of medical cost by near 30 % as well as milder adverse reactions as compared with the control group. Conclusion  RBV plus IFNα-2b for chronic hepatitis C genotype 2/3 may lead to higher RVR, EVR and EVR, and even sustained ETVR and SVR after reduced dose of IFN, which can reduce the financial burden and adverse drug reactions for such patients.

Key words: Hepatitis C, Chronic, Interferon alfa-2b, Ribavirin