摘要
目的分析聚乙二醇干扰素α-2a（Peg-IFN α-2a）与IFNα-2a治疗慢性丙型肝炎的疗效。方法采用回顾性队列研究方法，收集2010至2012年初次接受IFN抗病毒治疗的HCV患者188例，其中Peg-IFNα-2a组55例，IFNα-2a组133例，比较治疗前、治疗4、12、24、48周时两组HCV载量、ALT、AST之间的差异及不良反应发生情况。结果初始治疗前两组性别、年龄、吸烟、饮酒、HCV基因分型、HCV载量、肝功能等比较，P值均〉0．05，差异无统计学意义。Peg-IFNα-2a组和IFNα-Za组患者，抗病毒治疗前HCV载量、ALT、AST值均高于治疗4、12、24、48周时HCV载量，尸值均〈0．05，差异有统计学意义。Peg-IFNα-2a组治疗4周时HCV载量为（2．96±0．66）logl0IU／Inl，低于IFNα-2a组的（3．47±1．42）log10IU／nil，两组比较，F=4．14，P〈0．05，差异有统计学意义；Peg-IFNα-2a组快速病毒学应答率为72．720／0，高于IFNα-2a组的57．14％，两组比较，疋。=4．37，P=0．04，差异有统计学意义；两组生物化学应答率、早期病毒学应答率、治疗结束时宿毒学应答率及抗病毒治疗不良反应发生率比较，尸值均〉0．05，差异无统计学意义。结论Peg-IFNα-2a组初治慢性丙型肝炎快速病毒学应答率高于IFNα-2a组，但生物化学应答率、早期及治疗结束时病毒学应答率及不良反应发生率与IFNα-2a组比较，差异无统计学：意义，远期疗效差异仍需进一步随访观察。
Objective To perform a retrospective cohort study in order to determine the differences in short-term curative effect of ribavirin in and-eighty-eight tcombination with interferon alfa （IFNα）-2a vs. pegylated （Peg）- IFNa-2a in patients with chronic hepatitis C （CHC）. Methods One-hundred-reatment- haiye CHC patients who were administered combination therapy of ribavirin with IFNa from 2010 to 2012. One-hundred-and-thirty-three of the patients received the therapy with IFNa-2a and the remaining 55 received Peg-IFNa-2a. Hepatitis C virus （HCV） load and levels of alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were measured at treatment weeks 4, 12, 24, and 48. Adverse reactions were recorded. Differences between the groups were assessed by statistical analysis. Results The patients in the Peg-IFNa-2a group and the IFNa-2a group showed no significant difference in sex distribution, age, smoking habits, or drinking habits at baseline （all P 〉 0.05）. Both antiviral therapies significantly reduced the HCV load and levels of ALT and AST （baseline levels vs. all treatment weeks examined, P 〈 0.05）; however, the reduction in the HCV load at week 4 was significantly more robust with the Peg-IFNtt-2a therapy （（2.96 ± 0.66） log101U/ ml vs. （3.47 ± 1.42）1og10 IU/ml; F = 4.14, P = 0.04）. The Peg-IFNα-2a group also showed a significant higher rate of rapid virological response （RVR） than the IFNα-2a group （72.72% vs. 57.14%; Z2 = 4.37,P = 0.04）, but there were no statistically significant differences found between the two groups for early virological response rate （EVR）, endpoint antiviral treatment virologic response rate （ETR）, biochemical response rate, or rate of adverse reactions （allP 〉 0.05）. Conclusion Ribavirin in combination with Peg-IFNα-2a produces a better RVR than in combination with IFNα-2a. Yet, the EVR, ETR, biochemical response rate, and rate of adverse reactions is similar for the two forms of IFNα-2a, Further studies are required to determine the potential superiority of Peg-IFNα-2a for a long-term curative effect.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2014年第4期255-259,共5页
Chinese Journal of Hepatology
基金
国家自然科学基金（81271815）
关键词
肝炎病毒
丙型
干扰素
疗效比较研究
Hepatitis C virus
Interferon
Comparative effectiveness research
作者简介
王盟男，37岁，医学博士。
通信作者：李建生，Email：lijiansheng@medmail．com．cn
