Ide Tatsuya, Okamura Takashi, Kumashiro Ryukichi, Koga Yuriko, Hino Teruko, Hisamochi Akiko, Ogata Kei, Tanaka Kazuo, Kuwahara Reiichiro, Seki Ritsuko, Sata Michio
Second Department of Internal Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan.
Int J Mol Med. 2003 Jun;11(6):729-32.
One of the major side effects of ribavirin/interferon alpha combination therapy for chronic hepatitis C is hemolytic anemia. One of the causes of hemolytic anemia is considered to be decreasing deformability of erythrocytes resulting from the accumulation of phosphorylated ribavirin in erythrocytes. The administration of eicosapentaenoic acid (EPA), which has a wide variety of pharmacological actions, increases the deformability of erythrocytes. We conducted an uncontrolled pilot study of EPA therapy for patients with ribavirin-related anemia. Six patients with chronic hepatitis C, who had developed anemia while receiving combination therapy, were treated with an oral ethyl ester of EPA (1800 mg/day) for two months. The hemoglobin level of all six patients increased following EPA therapy. The mean hemoglobin level significantly increased from 10.8 g/dl to 11.4 g/dl one month after therapy was initiated (P<0.05), and this level was obtained again one month later (11.5 g/dl). None of the patients developed an adverse reaction. These findings suggest that EPA has a beneficial effect in patients with ribavirin-related anemia. Further study is required to confirm our results.
利巴韦林与α干扰素联合治疗慢性丙型肝炎的主要副作用之一是溶血性贫血。溶血性贫血的原因之一被认为是红细胞内磷酸化利巴韦林积累导致红细胞变形性降低。具有多种药理作用的二十碳五烯酸（EPA）的给药可增加红细胞的变形性。我们对EPA治疗利巴韦林相关性贫血患者进行了一项非对照试验研究。6例在接受联合治疗时出现贫血的慢性丙型肝炎患者，接受口服EPA乙酯（1800毫克/天）治疗两个月。EPA治疗后所有6例患者的血红蛋白水平均升高。治疗开始1个月后，平均血红蛋白水平从10.8克/分升显著升至11.4克/分升（P<0.05），1个月后再次达到该水平（11.5克/分升）。无一例患者出现不良反应。这些发现表明，EPA对利巴韦林相关性贫血患者有有益作用。需要进一步研究来证实我们的结果。
