摘要
目的探讨聚乙二醇干扰素α-2a联合利巴韦林对丙型肝炎抗病毒治疗的远期疗效与安全性分析。方法选取2004年2月至2006年10月126例经抗病毒治疗的丙型肝炎患者作为治疗组,另选取45例未进行抗病毒治疗的丙型肝炎患者作为对照组,比较两组患者的病毒学应答效果,累积随访8年内患者的远期疗效,进行安全性评价。结果治疗组患者获得cRVR39例(31.0%)、qRVR74例(58.7%)。对照组患者获得cRVR为6例(13.3%)、qRVR4例(8.9%);在EVR方面,治疗组在cEVR方面与对照组差异有非常显著性意义(P<0.01);治疗组患者获得ETVR106例(84.1%)、SVR87例(69.0%),对照组ETVR为10例(22.2%)、SVR为1例(2.2%)差异有非常显著性意义(P<0.01);累积随访达8年左右,发现未持续病毒学应答组患者在肝功能异常(74.36%)、全因病死率(23.08%)、HCV RNA阳性率(79.49%)、肝因性病死率(23.08%)、肝纤维化比例(23.08%)、肝硬化比例(20.51%)以及肝癌发生率(12.51%)均与持续病毒学应答组(分别为9.20%、8.05%、13.79%、2.39%、3.48%、2.39%、2.39%)、对照组(分别为95.56%、26.67%、95.56%、26.67%、28.89%、15.56%、24.44%)差异有统计学意义(P<0.01);未持续病毒学应答组与持续病毒学应答组各方面在血液流变学异常方面差异有统计学意义(P<0.05)。结论聚乙二醇干扰素联合利巴韦林治疗丙型肝炎患者获得持续病毒学应答效果明显增高,其远期疗效明显,且持续病毒学应答患者在全因性死亡率、肝因性死亡、肝硬化死亡率以及肝癌发生率等方面均低于非持续病毒学应答患者。
Objective To investigate the long-term efficacy and safety of pegylated interferon a-2a plus ribavirin for hepatitis C antiviral therapy. Methods For virological response analysis, 126 patients of hepatitis C, who had received antiviral therapy in our hospital from February 2004 to October 2006, were enrolled as treatment group, and another untreated 45 cases with hepatitis C were set as control group. An 8-year follow-up for long-term efficacy analysis and safety evaluation was carried out among those patients. Results There were significant differences in rapid virological response （RVR）, including complete RVR and partial RVR （P〈0.05 and P〈0.01） between treatment group and control group. In addition, there were also significant differences in complete early virological response （cEVR）, end of treatment virus response （EOT） and sustained virological response （SVR）[6（13.3%） vs. 4（8.9%/00）, 106（84.1%） vs. 10（22.2%） and 87 （69.0%） vs. 1（2.2%）, respectively, （P〈0.01）] between the two groups. During the cumulative follow-up for 8 years, abnormal liver function （74. 36%5, all-cause mortality （23. 08%）, positive rate of hepatitis C virus RNA （79. 49%）, mortality due to liver disease （23.08%）, hepatic fibrosis rate （23.08%）, liver cirrhosis rate （20.51%）, and liver cancer morbidity （12.51%） were computed in non-SVR group, which were statistically different （P〈0.01） from those in SVR group （9.20%, 8. 05%, 13. 79%, 2. 39%, 3. 48%, 2. 39% and 2. 39%, respectively） and control group （95. 56%, 26.67%, 95.56%, 26.67%, 28.89%, 15.56% and 24.44%, respectively）. Meanwhile, abnormal blood rheology in non- SVR group was statistically different （P〈0.05） from that in SVR group. Conclusion Combination of pegylated interferon and ribavirin for hepatitis C not only induced significantly efficient SVR but also sustained obvious long-term effect. Additionally, patients with SVR had lower all-cause mortality, mortality due to liver disease, incidence of cirrhosis compared with non-SVR patients.
出处
《肝脏》
2015年第10期783-785,826,共4页
Chinese Hepatology
