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目的探讨聚乙二醇干扰素α-2a(Peg-IFNα-2a)联合利巴韦林治疗慢性丙型肝炎的疗效以及影响因素。方法根据自身免疫抗体是否阳性,将81例慢性丙型肝炎患者分为阳性组(n=20)与阴性组(n=61),给予Peg-IFNα-2a与利巴韦林联合治疗48周。比较病毒学应答、复发率等评价指标。结果阳性组获得持续病毒学应答(SVR)(60.0%vs 83.6%)的比率显著低于阴性组,差异有统计学意义(P<0.05)。两组在干扰素抗病毒治疗史、合并糖尿病上差异有统计学意义(P<0.05)。Logistic回归分析显示,干扰素抗病毒治疗史、合并糖尿病是自身免疫抗体阳性慢性丙型肝炎获得SVR的危险因素。结论 Peg-IFNα-2a联合利巴韦林治疗自身免疫抗体阳性慢性丙型肝炎有效,但经干扰素抗病毒治疗、合并糖尿病可能是影响患者获得SVR的危险因素。
Objective To investigate the curative effect and influencing factors of Peg-IFNα-2a combined with ribavirin on chronic hepatitis C patients. Methods 81 patients with chronic hepatitis C were divided into positive group (n = 20) and negative group (n = 61) according to whether the autoimmune antibodies were positive. Peg-IFNα-2a and ribavirin were given for 48 weeks. Comparison of virological response, recurrence rate and other indicators. The positive rate of SVR (60.0% vs 83.6%) in the positive group was significantly lower than that in the negative group (P <0.05). There was significant difference between the two groups in the history of interferon antiviral therapy and diabetes (P <0.05). Logistic regression analysis showed that the history of interferon antiviral therapy combined with diabetes mellitus was a risk factor for SVR in autoimmune-antibody-positive chronic hepatitis C. Conclusions Peg-IFNα-2a combined with ribavirin is effective in treating autoimmune-antibody-positive chronic hepatitis C, but with interferon antiviral therapy and diabetes mellitus may be the risk factors for influencing SVR in patients.