聚乙二醇干扰素α-2a联合利巴韦林标准抗病毒治疗慢性丙型肝炎患者疗效再研究*

doi:10.3969/j.issn.1672-5069.2022.04.012

摘要/Abstract

摘要： 目的分析比较应用聚乙二醇干扰素α-2a联合利巴韦林(RBV)抗病毒治疗慢性丙型肝炎(CHC)患者的疗效。方法 2017年2月～2020年4月我院收治的102例CHC患者,采用随机数字表法将其分为对照组50例和观察组52例,分别给予利巴韦林(RBV)联合普通α-2b干扰素治疗或应用RBV联合聚乙二醇干扰素α-2a治疗6个月。采用实时荧光定量PCR法检测血清HCV RNA载量,使用流式细胞仪检测外周血T淋巴细胞亚群。结果观察组治疗结束时病毒学应答率(ETVR)为88.5%,显著高于对照组的62.0%(P＜0.05),持续病毒学应答率(SVR)为82.7%,显著高于对照组的62.0%(P＜0.05);在治疗结束时,观察组血清ALT水平为(36.8±4.1)U/L,显著低于对照组【(61.5±4.3)U/L,P＜0.05】,血清AST水平为(38.4±3.4)U/L,显著低于对照组【(51.6±3.6)U/L,P＜0.05】;在治疗4 w、12 w和24 w,观察组血清HCV RNA水平分别为(4.6±1.2)Ig IU/mL、(4.1±1.1)Ig IU/mL和 (3.6±0.9)Ig IU/mL,显著低于对照组【分别为(5.1±1.1)Ig IU/mL、(4.7±1.2)Ig IU/mL和(4.2±1.0)Ig IU/mL,P＜0.05】;在治疗结束时,观察组外周血CD3⁺细胞百分比为(73.8±7.5)%,显著高于对照组【(65.6±6.9)%,P＜0.05】,CD4⁺细胞百分比为(49.5±6.3)%,显著高于对照组【(34.8±5.8)%,P＜0.05】,而CD8⁺细胞百分比为(17.6±3.8)%,显著低于对照组【(25.9±4.6)%,P＜0.05】,CD4⁺/CD8⁺细胞比值为(1.0±0.2),显著低于对照组【(1.4±0.3),P＜0.05】。结论应用聚乙二醇干扰素α-2a联合RBV抗病毒治疗CHC患者疗效尚可,在不能应用直接抗病毒药物的情况下继续应用标准疗法仍可获得一定的抗病毒治疗效果。

关键词: 慢性丙型肝炎, 聚乙二醇干扰素α, 利巴韦林, 治疗

Abstract: Objective The aim of this study was to investigate the efficacy of standardized pegylated interferon α-2a (Peg-IFNα-2a) and ribavirin (RBV) combination in treatment of patients with chronic hepatitis C (CHC). Methods 102 patients with CHC were enrolled in our hospital between February 2017 and April 2020, and were divided randomly into control (n=50) and observation (n=52). The patients in the control received RBV and interferonα-2a therapy, and those in the observation were treated by RBV and Peg-IFNα-2a therapy. The regimen in both groups lasted for 6 months. The peripheral blood T lymphocyte subsets was detected by Flow cytometry. Results The end treatment virological response (ETVR) and the sustained virological response in the observation group were 88.5% and 82.7%, both significantly higher than 62.0% and 62.0%(P＜0.05) in the control group; at the end of treatment, serum ALT and AST levels in the observation were (36.8±4.1)U/L and (38.4±3.4)U/L, both significantly lower than [(61.5±4.3)U/L and(51.6±3.6)U/L, respectively, P＜0.05] in the control group; at week 4, 12 and 24, serum HCV RNA loads in the observation group were (4.6±1.2)Ig IU/mL, (4.1±1.1)Ig IU/mL and (3.6±0.9)Ig IU/mL, all significantly lower than [(5.1±1.1)Ig IU/mL, (4.7±1.2)Ig IU/mL and (4.2±1.0)Ig IU/mL, respectively, P＜0.05] in the control; at the end of the regimen, the percentage of peripheral blood CD3⁺ cells in the observation group was (73.8±7.5)%, significantly higher than [(65.6±6.9)%, P＜0.05], that of CD4⁺ cells was (49.5±6.3)%, significantly higher than [(34.8±5.8)%, P＜0.05], while that of CD8⁺ cells was (17.6±3.8)%, significantly lower than [(25.9±4.6)%, P＜0.05] and the ratio of CD4⁺/CD8⁺ cells was (1.0±0.2), significantly lower than [(1.4±0.3), P＜0.05] in the control group. Conclusion The standardized Peg-IFNα-2a and RBV antiviral therapy is still efficacious in treating patients with CHC, which might be carried out alternatively in case no direct antiviral agents is available.

Key words: Hepatitis C, Pegylated interferon α, Ribavirin, Therapy

徐欢, 王广丽, 董丹丹, 黄荷. 聚乙二醇干扰素α-2a联合利巴韦林标准抗病毒治疗慢性丙型肝炎患者疗效再研究^*[J]. 实用肝脏病杂志, 2022, 25(4): 500-503.

Xu Huan, Wang Guangli, Dong Dandan, et al. Efficacy of standardized pegylated interferon α-2a and ribavirin combination in treatment of patients with chronic hepatitis C[J]. Journal of Practical Hepatology, 2022, 25(4): 500-503.

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聚乙二醇干扰素α-2a联合利巴韦林标准抗病毒治疗慢性丙型肝炎患者疗效再研究^*

Efficacy of standardized pegylated interferon α-2a and ribavirin combination in treatment of patients with chronic hepatitis C

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