艾尔巴韦/格拉瑞韦治疗基因1b型慢性丙型肝炎患者疗效研究*

doi:10.3969/j.issn.1672-5069.2022.06.008

摘要/Abstract

摘要： 目的探讨应用艾尔巴韦/格拉瑞韦治疗基因1b型慢性丙型肝炎(CHC)患者的疗效。方法 2018年6月～2020年12月我院收治的68例基因1b型CHC患者,被随机分为观察组34例和对照组34例,分别给予艾尔巴韦/格拉瑞韦或利巴韦林联合聚乙二醇干扰素α-2a治疗24 w,随访24 w。采用ELISA法检测血清 L-选择素、C反应蛋白(CRP)、白细胞介素6(IL-6)和肿瘤坏死因子-α(TNF-α)。结果观察组快速病毒学应答、早期病毒学应答、治疗结束病毒学应答和持续病毒学应答率分别为70.6%、91.2%、97.1%和94.1%,显著高于对照组的41.2%、55.9%、64.7%和55.9%(P＜0.05); 在治疗4 w、12 w、24 w和随访24 w时,观察组血清HCV RNA水平分别为(1.5±0.9)lgIU/mL、(1.6±0.7)lgIU/mL、(1.2±0.6)lgIU/mL和(1.2±0.4)lgIU/mL,显著低于对照组【分别为(4.3±0.8)lgIU/mL、(4.7±0.9)lgIU/mL、(3.2±0.5)lgIU/mL和(3.2±0.5)lgIU/mL,P＜0.05】;在治疗24 w结束时,观察组血清L-选择素、CRP、IL-6和TNF-α水平分别为(816.3±161.4)ng/mL、(13.7±1.9)ng/L、(84.4±18.8)pg/mL和(1.2±0.3)ng/mL,显著低于对照组【分别为(1157.4±192.3)ng/mL、(16.3±2.0)ng/L、(115.9±20.5)pg/mL和(1.6±0.3)ng/mL,P＜0.05】;观察组外周血白细胞计数、血小板计数和血红蛋白水平分别为(5.4±1.1)×10⁹/L、(101.3±17.3)×10⁹/L和(120.8±19.5)g/L,显著高于对照组【分别为(3.2±0.8)×10⁹/L、(86.9±16.6)×10⁹/L和(101.6±16.2)g/L,P＜0.05】。结论应用艾尔巴韦/格拉瑞韦治疗基因1b型CHC患者疗效好,副作用少,可能与抑制了机体炎症反应有关。

关键词: 慢性丙型肝炎, 基因1b型, 艾尔巴韦/格拉瑞韦, 病毒学应答, 治疗

Abstract: Objective This study was aimed at exploring the response to elbavir/glarevir antiviral therapy in patients with genotype 1b chronic hepatitis C (CHC). Methods 68 patients with genotype 1b CHC were recruited in our hospital and were divided into observation (n=34) and control (n=34) group, receiving elbavir/glarevir or ribavirin and peg-interferonα-2a combination therapy for 24 weeks. All the patients were followed-up for 24 weeks. Serum L-selectin, C-reactive protein (CRP), interleukin- 6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were detected by ELISA. Results The rapid virological response, early virological response, end-of-treatment response and sustained virological response in the observation group were 70.6%, 91.2%, 97.1% and 94.1%, all much higher than 41.2%, 55.9%, 64.7% and 55.9%(P＜0.05) in the control; at the end of 4, 12, 24 week treatment and 24 week follow-up, serum HCV RNA loads in the observation group were (1.5±0.9)lgIU/mL,(1.6±0.7)lgIU/mL, (1.2±0.6)lgIU/mL and (1.2±0.4)lgIU/mL, significantly lower than [(4.3±0.8)lgIU/mL, (4.7±0.9)lgIU/mL, (3.2±0.5)lgIU/mL and (3.2±0.5)lgIU/mL, respectively, P＜0.05] in the control; at the end of 24 week treatment, serum L-selectin, CRP, IL-6 and TNF-α levels in the observation group were (816.3±161.4)ng/mL, (13.7±1.9)ng/L, (84.4±18.8)pg/mL and (1.2±0.3) ng/mL, all significantly lower than [(1157.4±192.3)ng/mL, (16.3±2.0)ng/L, (115.9±20.5)pg/mL and (1.6±0.3)ng/mL, respectively, P＜0.05] in the control group; the white blood cell counts, platelet counts and hemoglobin level in the observation were (5.4±1.1)×10⁹/L, (101.3±17.3)×10⁹/L and (120.8±19.5)g/L, all significantly higher than [(3.2±0.8)×10⁹/L, (86.9±16.6)×10⁹/L and (101.6±16.2)g/L, respectively, P＜0.05] in the control. Conclusion The application of elbavir/glarevir in the treatment of CHC patients with genotype 1b infection is efficacious, with low untoward effects, which might be related to the low body response of inflammatory reactions.

Key words: Hepatitis C, Genotype 1b, Elbavir/glarevir, Virological response, Therapy

许海玲, 秦刚, 薛红, 章颖. 艾尔巴韦/格拉瑞韦治疗基因1b型慢性丙型肝炎患者疗效研究^*[J]. 实用肝脏病杂志, 2022, 25(6): 788-791.

Xu Hailing, Qin Gang, Xue Hong, et al.. Response to elbavir/glarevir antiviral therapy in patients with genotype 1b chronic hepatitis C[J]. Journal of Practical Hepatology, 2022, 25(6): 788-791.

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艾尔巴韦/格拉瑞韦治疗基因1b型慢性丙型肝炎患者疗效研究^*

Response to elbavir/glarevir antiviral therapy in patients with genotype 1b chronic hepatitis C

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