抗病毒治疗的基因1b型慢性丙型肝炎患者疗效及其血清γ-干扰素和白细胞介素-10水平变化*

doi:10.3969/j.issn.1672-5069.2024.05.011

摘要/Abstract

摘要： 目的分析接受索磷布韦/达拉他韦或标准治疗方案治疗的基因1b型慢性丙型肝炎(CHC)患者疗效及其血清γ-干扰素(IFN-γ)和白细胞介素(IL)-10水平变化。方法 2020年5月～2023年2月我院收治的基因1b型CHC患者58例,其中30例观察组接受索磷布韦/达拉他韦治疗,另28例接受聚乙二醇干扰素α-2a联合利巴韦林治疗,均持续治疗24 w。采用ELISA法检测血清IFN-γ和IL-10水平。结果在治疗结束时,观察组白细胞、血小板计数和血红蛋白水平分别为(5.5±1.2)×10⁹/L、(116.2±19.5)×10⁹/L和(121.5±19.7)g/L,均显著高于对照组【分别为(4.6±1.1)×10⁹/L、(94.0±18.5)×10⁹/L和(104.7±16.8)g/L,P<0.05】;观察组血清丙氨酸氨基转移酶和天冬氨酸氨基转移酶水平分别为(36.0±5.0)U/L和(38.2±5.5)U/L,显著低于对照组【分别为(47.5±5.8)U/L和(51.9±6.3)U/L,P<0.05】;观察组血清C-反应蛋白和IL-10水平分别为(13.4±1.8) ng/L和(36.5±14.6)pg/mL,均显著低于对照组【分别为(16.7±2.2)ng/L和(64.0±28.2)pg/mL,P<0.05】,而血清IFN-γ水平为(19.2±2.0)pg/mL,显著高于对照组【(10.4±2.2)pg/mL,P<0.05】;观察组快速病毒学应答、早期病毒学应答、治疗结束时病毒学应答和持续病毒学应答率分别为73.3%、90.0%、100.0%和96.7%),均显著高于对照组的42.8%、53.6%、71.4%和60.7%(P<0.05);在治疗4 w时,46例应答组血清IFN-γ水平为(23.5±4.7)pg/mL,显著高于12例未应答组【(8.5±1.7)pg/mL,P<0.05】,而血清IL-10水平为(29.0±13.2)pg/mL,显著低于未应答组【(84.5±30.1)pg/mL,P<0.05】。结论应用索磷布韦/达拉他韦治疗基因1b型CHC患者疗效好,病毒学应答率高,可能与成功诱发机体抗病毒免疫反应有关。

关键词: 丙型肝炎, 索磷布韦/达拉他韦, 聚乙二醇干扰素α-2a, 细胞因子, 治疗

Abstract: Objective The aim of this study was to observe the antiviral efficacy and serum interferon-γ (IFN-γ) and interleukin-10 (IL)-10) level changes in patients with chronic hepatitis C (CHC) with genotype 1b infection. Methods 58 patients with CHC and genotype 1b infection were recruited in our hospital between May 2020 and February 2023, and the antiviral regimen by sorfosbuvir/daratavir was given in 30 patients in the observation group and by peginterferon α-2a and ribavirin combination was given in 28 patients in the control. The treatment lasted for 24 weeks in the two groups. Serum IFN-γ and IL-10 levels were measured by ELISA. Results At the end of the antiviral treatment, the white blood cell count, platelet count and hemoglobin concentration in the observation group were(5.5±1.2)×10⁹/L, (116.2±19.5)×10⁹/L and (121.5±19.7)g/L, all significantly higher than [(4.6±1.1)×10⁹/L, (94.0±18.5)×10⁹/L and (104.7±16.8)g/L, respectively, P<0.05] in the control; serum ALT and AST levels in the observation group were(36.0±5.0)U/L and (38.2±5.5)U/L, both significantly lower than [(47.5±5.8)U/L and (51.9±6.3) U/L, P<0.05] in the control; serum CRP and IL-10 levels in the observation group were (13.4±1.8) ng/L and (36.5±14.6)pg/mL, both significantly lower than [(16.7±2.2)ng/L and (64.0±28.2)pg/mL, P<0.05], while serum IFN-γ level was (19.2±2.0) pg/mL, significantly higher than [(10.4±2.2)pg/mL, P<0.05] in the control; the rapid virological response, early virological response, end-of-treatment response and sustained virological response in the observation group were 73.3%, 90.0%, 100.0% and 96.7%, all significantly higher than 42.8%, 53.6%, 71.4% and 60.7%(P<0.05) in the control group; at the end of four-week treatment, serum IFN-γ level in 46 responders was (23.5±4.7)pg/mL, much higher than [(8.5±1.7)pg/mL, P<0.05], while serum IL-10 level was (29.0±13.2)pg/mL, much lower than [(84.5±30.1)pg/mL, P<0.05] in twelve non-responders. Conclusion The application of sorfosbuvir and daratavir in the treatment of patients with genotype 1b CHC has a good efficacy, which might be be related to the inhibition of viral replication and the successful induction of antiviral immunization.

Key words: Hepatitis C, Sorfosbuvir/daratavir, Peginterferon α-2a, Cytokines, Therapy

刘雅光, 胡连智, 董一侠, 刘洋. 抗病毒治疗的基因1b型慢性丙型肝炎患者疗效及其血清γ-干扰素和白细胞介素-10水平变化^*[J]. 实用肝脏病杂志, 2024, 27(5): 689-692.

Liu Yaguang, Hu Lianzhi, Dong Yixia, et al. Antiviral efficacy and serum interferon-γ and interleukin-10 level changes in patients with chronic hepatitis C with genotype 1b infection[J]. Journal of Practical Hepatology, 2024, 27(5): 689-692.

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抗病毒治疗的基因1b型慢性丙型肝炎患者疗效及其血清γ-干扰素和白细胞介素-10水平变化^*

Antiviral efficacy and serum interferon-γ and interleukin-10 level changes in patients with chronic hepatitis C with genotype 1b infection

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