Aghemo Alessio, Rumi Maria Grazia, Monico Sara, Banderali Matteo, Russo Antonio, Ottaviani Francesco, Vigano Mauro, D'Ambrosio Roberta, Colombo Massimo
A. M. Migliavacca Center for Liver Disease First, Division of Gastroenterology, IRCCS Fondazione Ca' Granda Hospital, University of Milan, Milan, Italy.
Hepat Mon. 2011 Nov;11(11):918-24. doi: 10.5812/kowsar.1735143X.733. Epub 2011 Nov 30.
Xerostomia is a common adverse event of unknown etiology observed during pegylated interferon (PegIFN)/Ribavirin (Rbv) treatment.
To assess the frequency and mechanisms of xerostomia during PegIFN/Rbv therapy.
Thirty-one naïve patients with chronic hepatitis C consecutively received PegIFN-α2a (180 μg/week) plus Rbv (800-1200 mg/day). The controls were 10 patients with chronic hepatitis B who received PegIFN-α2a (180 μg/week). During treatment and follow-up, all patients underwent basal and masticatory stimulated sialometry,otorhinolaryngoiatric (ORL) examination, and a questionnaire survey to subjectively assess symptoms of oral dryness.
Twenty-seven patients on PegIFN/Rbv and 4 on PegIFN (87% vs. 40%, P = 0.006) reported xerostomia. Thirty patients on PegIFN/Rbv combination therapy and 2 patients on monotherapy had ORL signs of salivary gland hypofunction (97% vs. 20%, P < 0.0001).Mean basal (A) and stimulated (B) salivary flow rates (mL/min) progressively decreased during PegIFN/Rbv treatment (A, 0.49 at baseline vs. 0.17 at the end of treatment, P < 0.0001; B, 1.24 at baseline vs. 0.53 at the end of treatment, P = 0.0004). At week 24 following PegIFN/Rbv treatment, salivary flow rates were similar to baseline (A, 0.53 at the end of follow-up vs. 0.49 at baseline; B, 1.19 at the end of follow-up vs. 1.24 at baseline). Salivary function was unaffected in monotherapy patients.
Rbv causes salivary gland hypofunction in hepatitis C patients receiving PegIFN/Rbv therapy, which promptly reverts to normal upon cessation of treatment.
口干是聚乙二醇化干扰素（PegIFN）/利巴韦林（Rbv）治疗期间观察到的一种病因不明的常见不良事件。
评估PegIFN/Rbv治疗期间口干的发生率及机制。
31例初治慢性丙型肝炎患者连续接受PegIFN-α2a（180μg/周）加Rbv（800 - 1200mg/天）治疗。对照组为10例接受PegIFN-α2a（180μg/周）治疗的慢性乙型肝炎患者。在治疗及随访期间，所有患者均接受基础及咀嚼刺激唾液流量测定、耳鼻咽喉科（ORL）检查以及一项用于主观评估口腔干燥症状的问卷调查。
27例接受PegIFN/Rbv治疗的患者和4例接受PegIFN治疗的患者（87%对40%，P = 0.006）报告有口干症状。30例接受PegIFN/Rbv联合治疗的患者和2例接受单药治疗的患者有唾液腺功能减退的ORL体征（97%对20%，P < 0.0001）。在PegIFN/Rbv治疗期间，基础（A）和刺激（B）唾液流速（mL/分钟）逐渐降低（A，基线时为0.49，治疗结束时为0.17，P < 0.0001；B，基线时为1.24，治疗结束时为0.53，P = 0.0004）。在PegIFN/Rbv治疗后的第24周，唾液流速与基线相似（A，随访结束时为0.53，基线时为0.49；B，随访结束时为1.19，基线时为1.24）。单药治疗患者的唾液功能未受影响。
Rbv可导致接受PegIFN/Rbv治疗的丙型肝炎患者唾液腺功能减退，治疗停止后唾液腺功能迅速恢复正常。
