慢性丙型肝炎患者中与干扰素α-2b和利巴韦林联合治疗相关的视网膜病变的危险因素。
Risk factors for retinopathy associated with interferon alpha-2b and ribavirin combination therapy in patients with chronic hepatitis C.
作者信息
Okuse Chiaki, Yotsuyanagi Hiroshi, Nagase Yoshihiko, Kobayashi Yuhtaro, Yasuda Kiyomi, Koike Kazuhiko, Iino Shiro, Suzuki Michihiro, Itoh Fumio
机构信息
Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
出版信息
World J Gastroenterol. 2006 Jun 21;12(23):3756-9. doi: 10.3748/wjg.v12.i23.3756.
AIM
To elucidate the frequency and risk factors for retinopathy in patients with chronic hepatitis C who are treated by interferon-ribavirin combination therapy.
METHODS
We prospectively analyzed 73 patients with histologically confirmed chronic hepatitis C, who underwent combination therapy for 24 wk. Optic fundi were examined before, and 2, 4, 12 and 24 wk after the start of combination therapy.
RESULTS
Fourteen patients (19%) developed retinopathy, which was initially diagnosed by the appearance of a cotton wool spot in 12 patients. Retinal hemorrhage was observed in 5 patients. No patient complained of visual disturbance. Retinopathy disappeared in 9 patients (64%) despite the continuation of combination therapy. However, retinopathy persisted in 5 patients with retinal hemorrhage. A comparison of the clinical background between the groups with and without retinopathy showed no significant differences in age, gender, viral genotype, RNA level, white blood cell count, platelet count, prothrombin time, complications by diabetes mellitus or hypertension, or pretreatment arteriosclerotic changes in the optic fundi. However, multiple logistic regression analysis revealed that complication by hypertension was observed with a high frequency in the group with retinopathy (P = 0.004, OR = 245.918, 95% CI = 5.6-10786.2).
CONCLUSION
Retinopathy associated with combination therapy of interferon alpha-2b and ribavirin tends to develop in patients with hypertension.
目的
阐明接受干扰素 - 利巴韦林联合治疗的慢性丙型肝炎患者视网膜病变的发生率及危险因素。
方法
我们前瞻性分析了73例经组织学确诊的慢性丙型肝炎患者，他们接受了为期24周的联合治疗。在联合治疗开始前以及开始后2周、4周、12周和24周对眼底进行检查。
结果
14例患者（19%）发生视网膜病变，其中12例最初通过棉絮斑的出现得以诊断。5例患者观察到视网膜出血。无患者主诉视力障碍。尽管继续联合治疗，但9例患者（64%）的视网膜病变消失。然而，5例有视网膜出血的患者视网膜病变持续存在。有视网膜病变组和无视网膜病变组临床背景的比较显示，在年龄、性别、病毒基因型、RNA水平、白细胞计数、血小板计数、凝血酶原时间、糖尿病或高血压并发症或治疗前眼底动脉硬化改变方面无显著差异。然而，多因素logistic回归分析显示，视网膜病变组高血压并发症的发生率较高（P = 0.004，OR = 245.918，95%CI = 5.6 - 10786.2）。
结论
与干扰素α - 2b和利巴韦林联合治疗相关的视网膜病变倾向于在高血压患者中发生。
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