摘要
目的研究利巴韦林联合索磷布韦及达拉他韦治疗基因1b型低病毒载量慢性丙肝疗效。方法对90例2018年8月到2020年8月因基因1b型低病毒载量慢性HCV感染来我院治疗的患者进行抽签分组,抽中奇数签纳入A组,偶数签纳入B组,均为45例,A组采用常规利巴韦林联合聚乙二醇干扰素α皮下注射治疗,B组在此基础上应用索磷布韦联合达拉他韦,比较两组治疗期间HCV RNA转阴率及治疗结束后持续病毒应答(SVR)发生率,比较两组治疗前后ALT、总胆红素(TBil)、AST水平,另比较两组治疗期间不良反应发生率。结果两组各时段HCV RNA转阴率(62.22%比66.67%,86.67%比91.11%,93.33%比93.33%)、SVR发生率(91.11%比93.33%,84.44%比88.89%,80.00%比86.67%)比较差异无统计学意义(P>0.05);两组治疗8周、12周HCV RNA转阴率显著高于治疗4周(86.67%、93.33%比62.22,91.11%、93.33%比66.67%,P<0.05)。B组治疗后AST[(27.56±4.32)U/L]、ALT[(35.42±6.71)U/L]均明显低于治疗前[(72.58±6.43)U/L、(117.58±15.46)U/L]及A组[(31.25±5.34)U/L、(42.38±5.47)U/L,P<0.05];两组治疗后TBil[(18.54±2.34)μmol/L、(18.16±2.54)μmol/L]显著低于治疗前[(20.46±4.31)、(20.53±4.38)μmol/L,P<0.05]。A组不良反应总发生率为31.11%,与B组46.67%比较差异无统计学意义(P>0.05)。结论利巴韦林联合索磷布韦及达拉他韦治疗基因1b型低病毒载量慢性丙型肝炎具有良好临床疗效。
Objective To study the efficacy of ribavirin combined with sofbuvir and dalatavir in the treatment of genotype 1b low viral load chronic hepatitis C.Methods From August 2018 to August 2020,90 patients with chronic HCV infection due to low viral load of genotype 1b in our hospital were randomly divided into group A and group B,with 45 cases in each group,Group A was treated with conventional ribavirin combined with subcutaneous injection of ethylene glycol interferonα,and group B was treated with sothibuvir combined with dalatavir on the basis of conventional ribavirin combined with subcutaneous injection of ethylene glycol interferonα,The levels of alanine aminotransferase(ALT),total bilirubin(TBIL)and aspartate aminotransferase(AST)before and after treatment were compared between the two groups,and the incidence of adverse reactions during treatment was compared between the two groups.Results There was no significant difference in the negative rate of HCV-RNA(62.22%vs66.67%,86.67%vs91.11%,93.33%vs93.33%)and the incidence of SVR(91.11%vs93.33%,84.44%vs88.89%,80.00%vs86.67%)between the two groups at each time point(P>0.05);the negative rate of HCV-RNA(86.67%、93.33%vs62.22,91.11%、93.33%vs66.67%)in the two groups at 8 weeks and 12 weeks of treatment was significantly higher than that at 4 weeks of treatment,and the difference was statistically significant(P<0.05).After treatment,AST[(27.56±4.32)U/L]and ALT[(35.42±6.71)U/L]in group B were significantly lower than those before treatment[(72.58±6.43)U/L、(117.58±15.46)U/L]and the group A[(31.25±5.34)U/L、(42.38±5.47)U/L],the difference was statistically significant(P<0.05);TBil in two groups after treatment[(18.54±2.34)、(18.16±2.54)μmol/L]was significantly lower than that before treatment[(20.46±4.31)、(20.53±4.38)μmol/L],the difference was statistically significant(P<0.05).The total incidence of adverse reactions in group A was 31.11%,which was not significantly different from 46.67%in group B(P>0.05).Conclusion Ribavirin combined with sofbuvir and dalatavir has good clinical efficacy in the treatment of genotype 1b low viral load chronic hepatitis C.
作者
周静
陆宇红
王欣
ZHOU Jing;LU Yu-hong;WANG Xin(Department of Infection,the Fifth People′s Hospital of Wuxi,Jiangsu 214000,China)
出处
《肝脏》
2021年第10期1154-1156,1169,共4页
Chinese Hepatology
