【摘要】 目的:观察聚乙二醇干扰素α-2b(pegylated interferonα-2b,Peg-IFNα-2b)分层方法治疗白细胞(WBC)减少慢性丙型肝炎(CHC)的临床疗效。方法:将入组的105例患者分为3组,均使用保肝降酶药物,A组患者初始加用Peg-IFNα-2b,50μg,1次/周,B组患者初始加用普通干扰素α(IFN-α)1MU/次,1次/隔日,均皮下注射。两组患者均同时口服利巴韦林300mg/次,3次/d。根据患者反应,逐渐加大IFN剂量,密切监测血常规及不良反应,必要时采用辅助升白细胞药物。最后Peg-IFNα-2b达到80μg/次,1次/周,IFNα达到3MU/次,1次/隔日。C组患者仅使用保肝降酶药物。疗程1年。结果:在治疗1年时A、B、C 3组患者组ALT分别为(34±22)U/L、(67±44)U/L、(154±58)U/L,AST分别为(40±12)U/L、(79±32)U/L、(139±86)U/L;透明质酸(HA)分别为(48.13±30.21)μg/L、(89.34±76.42)μg/L、(201.34±106.21)μg/L,层粘蛋白(LN)分别为(102.1±79.52)μg/L、(239±87.54)μg/L、(536.68±358.35)μg/L,A、B组显著低于C组(P<0.05),A组显著低于B组(P<0.05);腹水出现率分别为0、0、10%;门静脉宽≥1.3cm比率分别为0、3.85%、10%;脾厚>4cm比率分别为4.34%、7.69%、16.67%,A、B组显著低于C组(P<0.05),A组显著低于B组(P<0.05);丙型肝炎病毒核糖核酸(HCV RNA)<1000IU/ml比率分别为91.30%、59.61%、0;WBC>3.0×109/L比率分别为91.30%、59.61%、0,A、B组显著高于C组(P<0.05),A组显著高于B组(P<0.05)。结论:白细胞减少的CHC患者可予干扰素抗病毒治疗。更多还原

【Abstract】 Objective: To investigate the clinical efficacy of pegylated interferon a-2b( Peg-IFNα-2b) treatment of white blood cells less than 3. 0X109/ L repeatedly elevated transaminase in patients with chronic hepatitis C. Methods: 105 patients were divided into three groups,three groups of patients the use of protecting liver and reducing enzyme drugs. Group A with initial plus PEG-interferon α-2b( Peg-IFNα-2b) 50 μg once a week,group B with IFN-α plus the initial 1MU,1 every other day,subcutaneous injection of started applications. The two groups were using the Ribavirin 900 mg / day application. Based on the reaction of patients,the dose increase gradually,close monitoring of blood routine,and other adverse reactions,increasing leukocyte drug assistance when necessary. Finally Peg-IFNα-2b reached 80μg once a week,IFN-α to 3MU 1 every other day,subcutaneous injection. Observation of 1 years。Result: In the 1 year treatment A,B,C group in glutamic-pyruvic transaminase( ALT) were( 34 ± 22) U / L,( 67 ± 44) U / L,( 154 ± 58) U / L. Glutamic-oxalacetic transaminase( AST)were( 40 ± 12) U / L,( 79 ± 32) U / L,( 139 ± 86) U / L. Hyaluronic acid( HA) respectively( 48. 13 ± 30. 21) μg / L,( 89. 34 ± 76.42) μg / L,( 201. 34 ± 106. 21) μg / L. Laminin( LN) were( 102. 1 ± 79. 52) μg / L,( 239 ± 87. 54) μg / L,( 536. 68 ± 358. 35) μg / L.Group A and B Were significantly lower than that of group C( P < 0. 05),group A was significantly lower than that of group B( P < 0. 05).The ascites proportion were 0,0,10%. Portal vein width≥1. 3cm ratio were 0、3. 85% 、10%. Ratio of spleen thickness > 4cm were 4.34%,7. 69%,16. 67%. Group A and B were significantly lower than that of group C( P < 0. 05),group A was significantly lower than that of group B( P < 0. 05). Ratio of hepatitis C virus ribonucleic acid( HCV RNA) < 1000 IU / ml were 91. 30%,59. 61%,0 and the proportion of white blood cell( WBC) > 3. 0 × 109/ L were 91. 30%,59. 61%,0. Group A and B were significantly higher than that of group C( P < 0. 05),group A was significantly higher than that of group B( P < 0. 05). Conclusion: White blood cells reduce patients with chronic hepatitis C can be treated by IFN-α antiviral therapy.更多还原