摘要
目的观察利巴韦林（RBV）联合不同剂量干扰素（IFN）OL-2b治疗基因2、3型慢性丙型肝炎的临床疗效。方法将2009年4月至2012年1月收治的46例基因2、3型慢性丙型肝炎患者分为治疗组24例和对照组22例，两组均在第1个月每日肌肉注射IFNα-2b6MU1次；治疗组在第2个月隔日肌肉注射IFNα-2b6MU1次，在第3个月及以后隔日肌肉注射IFNα-2b3MU1次；对照组在第2个月及以后隔日肌肉注射IFNα-2b6MU1次；两组均每日分3次口服RBV900～1200mg，疗程均为6个月；两组获得治疗结束时病毒学应答（ETVR）的患者在疗程结束后6个月时随访；无应答（NR）的患者延长疗程3个月。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；比较两组治疗费用和不良反应。计数资料组间比较采用，检验。结果治疗组24例和对照组22例获得RVR、EVR、EVR均较高，分别为15例（62．50％）和13例（59．09％）（X^2=0．056，P〉0．05）、17例（70．83％）和15例（68．18％）（X^2=0．038，P〉0．05）、20例（83．33％）和19例（86．36％）（X^2=0．082，P〉0．05）；治疗组和对照组NR均较低，分别为4例（16．67％）和3例（13．64％）（X^2=0．082，P〉0．05）；治疗组和对照组获得SVR也较高，分别为18例（75．00％）和17例（77．27％）（X^2=0．033，P〉0．05），差异均无统计学意义。治疗组使用IFNα-2b的总量及治疗费用比对照组少近30％，药物不良反应也较轻。结论RBV联合IFNα-2b“诱导疗法”治疗基因2、3型慢性丙型肝炎可获得较高的RVR、EVR，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。
Objective To investigate the clinical efficacy of ribavirin （RBV） combined with different doses of interferon α - 2b （ IFN α - 2b） in patients with chronic hepatitis C genotypes 2 and 3. Methods Forty - six patients who were admitted for chronic hepatitis C geno-types 2 and 3 from April 2009 to January 2012 were assigned to treatment group （ n = 24 ） and control group （ n = 22）. Both groups received intramuscular injection of IFN α -2b at a dose of 6 MU once daily in the first month. In the second month, the treatment group received in-tramuscular injection of IFN α -2b at a dose of 6 MU once every other day, and from the third month onwards, the treatment group received intramuscular injection of IFN α - 2b at a dose of 3 MU once every other day. The control group received intramuscular injection of IFN α - 2b at a dose of 6 MU once every other day from the second month onwards. In addition, both groups received oral RBV （900-1200 mg） three times daily for six months. The course of treatment was six months in both groups. The patients in the two groups who achieved end - of- treatment virologic response （ETVR） were followed up at six months after the treatment, whereas those with no response （NR） were treated for additional three months. Rapid viral response （RVR） , early virologic response （EVR） , ETVR, NR, and sustained virologic re-sponse （SVR） were compared between the two groups after the treatment. The cost of treatment and adverse reactions were also compared between the two groups. Statistical analysis was performed with SPSS 11.0, and comparison of numeration data between the two groups was conducted using the chi - square test. Results Both groups had high rates of RVR [ 15 （ 62.50% ） vs 13 （59.09%）, X^2 = 0. 056, P 〉 0.05], EVR [17 （70.83%） vsl5 （68.18%）,X^2= 0.038, P〉0.05], ETVR [20 （83.33%） vs 19 （86.36%）,X^2 =0.082, P〉 0.05 ], and SVR [ 18 （75.00%） vs 17 （77.27%）, X^2 =0. 033, P 〉0.05 1. The rate of NR was low in the treatment group and control group [4 （ 16.67% ） vs 3 （ 13.64% ）, X^2 =0. 082, P 〉0. 05]. The use of IFN α -2b and cost of treatment in the treatment group were nearly 30% less than those in the control group, and the treatment group also experienced milder adverse reactions. Conclusion For pa- tients with chronic hepatitis C genotypes 2 and 3, RBV combined with IFN α - 2b at an induction dose can lead to relatively high rates of RVR and EVR, and RBV plus IFN α - 2b at a maintenance dose can also result in relatively high rates of ETVR and SVR, thereby helping to reduce financial burden on patients and minimize adverse reactions.
出处
《临床肝胆病杂志》
CAS
2013年第10期780-783,共4页
Journal of Clinical Hepatology
