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学科主题: 感染疾病科
题名:
冷球蛋白血症对丙型肝炎患者病毒学应答的影响
其他题名: The effect of cryoglobulinemia on the antiviral therapy in patients with chronic hepatitis C
作者: 范晓红1; 王力芬1; 刘林昌1; 姚英1; 单媛1; 陆海英1; 吴赤红1; 徐小元1; 魏来1
关键词: 肝炎,丙型,慢性 ; 冷球蛋白血症 ; 病毒学应答 ; 基因型 ; Hepatitis C,chronic ; Cryoglobulinemia ; Virological response ; Genotype
刊名: 中华肝脏病杂志
发表日期: 2011
DOI: 10.3760/cma.j.issn.1007-3418.2011.10.001
卷: 19, 期:10, 页:721-725
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 探讨在应用聚乙二醇干扰素α-2a联合利巴韦林抗病毒治疗的慢性丙型肝炎(CHC)患者中,冷球蛋白血症对抗病毒治疗效果的影响. 方法 40例接受聚乙二醇干扰素α-2a联合利巴韦林抗病毒治疗的CHC患者进入研究,检测HCV基因型与基线、用药后4周、12周及治疗结束后24周患者血清HCV RNA水平,并检测基线患者血清中的冷球蛋白.连续型变量用独立样本t检验或秩和检验,分类资料用x2检验或Fisher' s精确概率法,对抗病毒治疗效果相关影响因素的分析用多元logistic回归分析.结果 治疗4周后快速病毒学应答发生率在冷球蛋白阳性患者(6/18,33.3%)低于阴性患者(15/22,68.2%,P=0.028).冷球蛋白阳性患者的持续病毒学应答发生率也低于阴性患者(0对比6/6,P=0.012).结论 冷球蛋白阳性的CHC患者快速病毒学及持续病毒学应答疗效低于冷球蛋白阴性的CHC患者. Objective To investigate the possible influence ofcryoglobulinemia on the antiviral effect in chronic hepatitis C patients,who were treated with combination therapy of pegylated interferon alpha-2a and ribavirin.Methods Forty consecutive patients with chronic hepatitis C (CHC) were enrolled in the study.They received pegylated interferon alfa-2a (40kD,180μg/w) along with ribavirin.Baseline cryoglobulins were detected in the sera by cryoprecitation.Hepatitis C virus (HCV) genotyping was performed and HCV viral load was detected at baseline,and at 4,12 weeks during treatment,24 weeks after cessation of treatment.Results Eighteen (45.0%) patients infected with HCV were cryoglobulins positive at baseline.Mean serum HCV RNA level in cryoglobulins positive patients was higher than that in cryoglobulins negative patients (6.36±0.63 vs.5.70±1.20,P=0.032).The rapid virological response (RVR) rate was statically different between cryoglobulins positive patients and cryoglobulins negative ones (6/18,33.3% vs.15/22,68.2%,P= 0.028).In contrast,no difference was found in early virological response (EVR) rate between the cryoglobulins positive patients and cryoglobulins negative ones (14/17,82.4% vs.18/21,85.7%,P-1.0).Sustained virological response (SVR) rate in cryoglobulins positive and cryoglobulins negative was different (0/3,0 vs 6/6,100%,P=0.012).The rate of patients achieved RVR was different between the patients infected with HCV genotype 1 b of two groups (cryoglobulins positive:2/13,15.4% vs cryoglobulins negative 14/21; 66.7%,P= 0.005).However,the rate of EVR in patients infected HCV genotype 1 b was not statistically different (cryoglobulins positive:9/12,75.0% vs.cryoglobulins negative 17/20; 81.2%,P=0.647).Conclusion The rates of RVR and SVR achievement in cryoglobulinemia positive CHC patients are lower than those in cryoglobulinemia negative CHC patients.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/41646
Appears in Collections:北京大学第一临床医学院_感染疾病科_期刊论文

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作者单位: 1.100034,北京大学第一医院感染疾病科
2.100034,北京大学第一医院肾内科
3.北京大学人民医院肝病研究所
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