索非布韦联合α-干扰素治疗慢性丙型肝炎患者疗效比较的Meta分析

doi:10.3969/j.issn.1672-5069.2018.02.016

摘要/Abstract

摘要： 目的评价索非布韦（SOF）联合α-干扰素（PEG-IFN）与索非布韦或干扰素治疗慢性丙型肝炎患者的疗效。方法检索 PubMed、Cochrane Library、中国期刊全文数据库（CNKI）、中国生物医学文献数据库（CBM）、万方数据库及中文科技期刊全文数据库（VIP）等数据库,纳入索非布韦联合干扰素与索非布韦或干扰素治疗慢性丙型肝炎患者的临床随机对照试验研究。采用Revman 5.2软件进行Meta分析。结果纳入9篇文献,共827例慢性丙型肝炎患者,其中5篇研究比较了SOF/PEG-IFN/利巴韦林（RBV）治疗的339例与SOF/RBV治疗的269例患者,4篇研究比较了SOF/PEG-IFN/RBV治疗的105例与PEG-IFN/RBV治疗的114例患者。Mate分析结果显示,SOF/PEG-IFN/RBV组快速病毒学应答率（RVR）显著高于SOF/RBV组（86.7% 对71.7%,P=0.002）,与PEG-IFN/RBV组比为91.7% 对32.3%（P=0.006）;SOF/PEG-IFN/RBV组持续病毒学应答率（SVR）显著高于PEG-IFN/RBV组（85.7%对44.2%,P<0.00001）,但与SOF/RBV组比,差异无统计学意义（89% 对74.1%,P=0.16）;SOF/PEG-IFN/RBV组头疼、疲劳、恶心、皮疹、肌痛、食欲减退、关节痛、发热、贫血发生率较SOF/RBV组高,且差异具有统计学意义（P<0.05）。结论索非布韦联合α-干扰素和利巴韦林治疗相比索非布韦联合利巴韦林或聚乙二醇干扰素联合利巴韦林治疗慢性丙型肝炎患者可获得更高的快速病毒学应答率,而不良反应发生率也较索非布韦联合利巴韦林治疗组高。

关键词: 慢性丙型肝炎, 索非布韦, &alpha, -干扰素, 利巴韦林, Meta分析

Abstract: Objective s To evaluate the efficacy of combination sofosbuvir and pegylated interferon-α in the treatment of patients chronic hepatitis C（CHC）. Methods We searched PUBMED,Cochrane Library,CNKI,CBM,VIP database for studies on combination sofosbuvir and pegylated interferonα versus sofosbuvir or pegylated interferon-α therapy in patients with CHC up to Mar. 2017. We performed the Meta-analysis by using the Revman 5.2. Results Nine studies were finally obtained including 827 patients with CHC,5 studies reported the observation between SOF/PEG-IFN/RBV （n=339） and SOF/RBV （n=269） and 4 studies reported the viral response between SOF/PEG-IFN/RBV（n=105） and PEG-IFN/RBV（n=114）. The results of Meta-analysis showed that the RVR in SOF/PEG-IFN/RBV group was higher than in SOF/RBV or in PEG-IFN/RBV group（86.7% vs. 71.7%,P=0.002 and 91.7% vs. 32.3%,P=0.006）;the SVR in SOF/PEG-IFN/RBV group was higher than in PEG-IFN/RBV group（85.7% vs. 44.2%,P<0.00001）,while there was no statistical difference between SOF/PEG-IFN/RBV group and SOF/RBV group（89.0% vs. 74.1%,P=0.16）;the adverse events,such as headache,fatigue,nausea,rash,muscle pain,decreased appetite,arthralgia,fever and anemia in SOF/PEG-IFN/RBV group was higher than in SOF/RBV group. Conclusion The efficacy of combination treatment of SOF/PEG-IFN/RBV is better than SOF/RBV or PEG-IFN/RBV with higher RVR or SVR for patients with CHC.

Key words: Chronic hepatitis C, Sofosbuvir, Pegylated interferon-α, Ribavirin, Meta-analysis

焦方舟, 张海月, 张文斌, 王鲁文, 龚作炯. 索非布韦联合α-干扰素治疗慢性丙型肝炎患者疗效比较的Meta分析[J]. 实用肝脏病杂志, 2018, 21(2): 220-224.

Jiao Fangzhou, Zhang Haiyue, Zhang Wenbin, et al. Efficacy of combination sofosbuvir and pegylated interferon-α in treatment of patients with chronic hepatitis C:a Meta-analysis[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2018, 21(2): 220-224.

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