聚乙二醇干扰素α联合利巴韦林治疗难治性慢性丙型肝炎过程中血常规变化与疗效的相关性

陈晓云; 郑艳红; 金怡; 于海滨; 马丽娜; 陈新月

doi:10.3969/j.issn.1001-5256.2016.07.021

聚乙二醇干扰素α联合利巴韦林治疗难治性慢性丙型肝炎过程中血常规变化与疗效的相关性

DOI: 10.3969/j.issn.1001-5256.2016.07.021

首都医科大学附属北京佑安医院

基金项目:

“十二·五”国家科技重大专项(2012ZX10002003-004-002)；

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中图分类号: R512.63
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出版历程
- 出版日期: 2016-07-20

Correlation between routine blood test results and antiviral effect in patients with refractory chronic hepatitis C treated with pegylated interferon-α

Research funding:

摘要

摘要: 目的观察难治性慢性丙型肝炎标准治疗过程中血常规的变化与抗病毒疗效的关系。方法收集2011年9月-2012年12月于首都医科大学附属北京佑安医院就诊的难治性慢性丙型肝炎初治患者63例,给予聚乙二醇干扰素α-2a（180μg/周）联合利巴韦林治疗48周,分别在基线、治疗4、12、24、48周和随访24周时进行HCV RNA及血常规的检测,分析血常规与疗效的相关性。根据是否获得持续病毒学应答（SVR）,分为SVR组和n SVR组。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验;采用简单线性相关分析法进行相关性分析。结果 63例患者有3例失访,余下60例均完成抗病毒治疗和24周随访,其中46例获得SVR,SVR率为76.7%;SVR组患者治疗4、12、24周时的淋巴细胞计数（LYPH）、白细胞计数（WBC）及中性粒细胞计数（NUET）均低于n SVR组,并且在12周时差异均有统计学意义（t值分别为3.398、2.766、2.037,P值均<0.05）,在24周时两组WBC及NUET差异亦均有统计学意义（t值分别为2.559、2.151,P值均<0.05）;此外SVR组患者...
- 肝炎,丙型,慢性 /
- 干扰素α-2a /
- 淋巴细胞计数 /
- 中性白细胞 /
- 白细胞计数
Abstract: Objective To investigate the correlation between the changes in routine blood test results and antiviral effect in patients with refractory chronic hepatitis C receiving standard treatment. Methods A total of 63 previously untreated patients with refractory chronic hepatitis C who visited Beijing You An Hospital,Capital Medical University,from September 2011 to December 2012 were enrolled. The patients were treated with pegylated interferon- α- 2a 180 μg / week and ribavirin( RBV) for 48 weeks. HCV RNA measurement and routine blood tests were performed at baseline and weeks 4,12,and 24 of treatment to analyze the correlation between routine blood test results and antiviral effect. According to the status of sustained virologic response( SVR),the patients were divided into SVR group and n SVR group. The t- test was used for comparison of continuous data between groups,the chi- square test was used for comparison of categorical data between groups,and a simple linear correlation analysis was performed. Results Of the 63 patients,three were lost to follow- up,and the other 60 patients completed the antiviral therapy and 24- week follow- up; among the 60 patients,46 achieved SVR,resulting in an SVR rate of76. 7%. Compared with the n SVR group,the SVR group showed lower absolute lymphocyte count( LYPH),white blood cell count( WBC),and absolute neutrophil count( NUET),and the three indicators were significantly different between the two groups at 12 weeks( t = 3. 398,2. 766,and 2. 037,all P < 0. 05); WBC and NUET still showed significant differences between the two groups at 24 weeks( t = 2. 559 and 2. 151,both P < 0. 05). In addition,at week 4 of treatment,the SVR group showed significantly greater reductions in these three indicators from baseline compared with the n SVR group,LYPH showed significant different between the two groups( t = 2. 26,P =0. 03). At weeks 4 and 12 of treatment,LYPH,WBC,and NEUT were positively correlated with the reduction in HCV RNA( r = 0. 36,0. 45,0. 37,0. 47,0. 61,and 0. 33,all P < 0. 05). Conclusion The reductions in LYPH,WBC,and NEUT can be used as predictive indicators for antiviral effect in patients with refractory chronic hepatitis C.
- hepatitis C /
- chronic /
- interferon alpha-2a /
- lymphocyte count /
- neutrophils

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参考文献(14)

[1]MOHD HANAFIAH K,GROEGER J,FLAXMAN AD,et al.Global epidemiology of hepatitis C virus infection:new estimates of age-specific antibody to HCV seroprevalence[J].Hepatology,2013,57(4):1333-1342.

[2] WHO guide lines for the screening,care and treatment of persons with hepatitis C infection[EB/OL].[2014-04].http://www.who.int/hepatitis/publications/hepatitis-c-guidelines/en/.

[3]CHEN YS,LI L,CUI FQ,et al.A sero-epidemiological study on hepatitis C in China[J].Chin J Epidemiol,2011,32(9):888-891.(in Chinese)陈园生,李黎,崔富强,等.中国丙型肝炎血清流行病学研究[J].中华流行病学杂志,2011,32(9):888-891.

[4]Chinese Society of Hepatology and Chinese Society of Infectious Diseases,Chinese Medical Association.The guideline of prevention and treatment for hepatitis C:a 2015 update[J].J Clin Hepatol,2015,31(12):1961-1979.(in Chinese)中华医学会肝病学分会,中华医学会感染病学分会.丙型肝炎防治指南(2015年更新版)[J].临床肝胆病杂志,2015,31(12):1961-1979.

[5]CHEN XY,SHANG J,YANG RF,et al.High sustained virological response to optimized therapy for refractory chronic hepatitis C treatment-na(i)ve patients:a multicenter randomized study[J].Chin J Hepatol,2015,23(6):412-417.(in Chinese)陈新月,尚佳,杨瑞锋,等.难治性慢性丙型肝炎初治患者优化治疗后的病毒学应答率研究[J].中华肝脏病杂志,2015,23(6):412-417.

[6]Chinese Society of Hepatology and Chinese Society of Infectious Diseases and Parasitology,Chinese Medical Association.Guidelines for prevention and treatment of hepatitis C[J].Natl Med J China,2004,84(9):775-780.(in Chinese)中华医学会肝病学分会、传染病与寄生虫病学分会.丙型肝炎防治指南[J].中华医学杂志,2004,84(9):775-780.

[7] LIU CH,LIU CJ,LIN CL,et al.Pegylated interferon-alpha-2a plus ribavirin for treatment-naive Asian patients with hepatitis C virus genotype 1 infection:a multicenter,randomized controlled trial[J].Clin Infect Dis,2008,47(10):1260-1269.

[8] ZHAO SH,CHU YL,CHENG DX,et al.Treatment with peginterferon plus ribavirin vs.interferon plus ribavirin for 48 weeks in Chinese patients with chronic hepatitis C[J].Int J Clin Pract,2009,63(9):1334-1339.

[9]LINDSAY KL,MORISHIMA C,WRIGHT EC,et al.Blunted cytopenias and weight loss:new correlates of virologic null response to re-treatment of chronic hepatitis C[J].Clin Gastroenterol Hepatol,2008,6(2):234-241.

[10]CHUNG RT,POORDAD FF,HASSANEIN T,et al.Association of host pharmacodynamic effects with virologic response to pegylated interferon alfa-2a/ribavirin in chronic hepatitis C[J].Hepatology,2010,52(6):1906-1914.

[11]MARTINEZ-CAMACHO A,KHAOUSTOV VI,ADAM E,et al.Lymphocytosis as a predictor of poor response to treatment of hepatitis C[J].Clin Res Hepatol Gastroenterol,2011,35(1):34-40.

[12] CLAASSEN MA,de KNEGT RJ,JANSSEN HL,et al.Retention of CD4+CD25+FoxP 3+regulatory T cells in the liver after therapy-induced hepatitis C virus eradication in humans[J].J Virol,2011,85(11):5323-5330.

[13] SALAZAR-MATHER TP,ORANGE JS,BIRON CA.Early murine cytomegalovirus(MCMV)infection induces liver natural killer(NK)cell inflammation and protection through macrophage inflammatory protein 1α(MIP-1α)-dependent pathways[J].J Exp Med,1998,187(1):1-14.

[14]CHEN XY,ZHANG YH,MA LN,et al.Changes in NK cells and regulatory T cells among patients with refractory chronic hepatitis Cduring antiviral treatment[J].J Clin Hepatol,2014,30(6):508-513.(in Chinese)陈晓云,张永宏,马丽娜,等.难治性慢性丙型肝炎患者抗病毒治疗中NK细胞和Treg细胞的动态变化[J].临床肝胆病杂志,2014,30(6):508-513.

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