Sun Li-jie, Yu Jian-wu, Kang Peng, Zhao Yong-hua, Yan Bing-zhu
Department of Infectious Diseases, Harbin Medical University, Harbin, China.
Zhonghua Nei Ke Za Zhi. 2012 Jan;51(1):46-50.
To investigate the correlation between neutropenia (ANC) incidence and infection during treatment with peginterferon alfa and ribavirin for chronic hepatitis C.
A retrospective cohort study of 399 patients treated with peginterferon and ribavirin derived from database of Department of Infectious Diseases, the Second Affiliated Hospital, Harbin Medical University was conducted. The incidence of infections and their relation with ANC were investigated. Potential risk factors for infection were identified by multivariate analysis.
During treatment, neutropenia (ANC < 1.50 × 10(9)/L) occurred in 251 patients. Among which, mild neutropenia [ANC: (> 0.75 - < 1.50) × 10(9)/L], moderate neutropenia [ANC: (0.50 - 0.75) × 10(9)/L] and severe neutropenia (ANC < 0.50 × 10(9)/L) occurred in 132 patients, 103 patients and 16 patients, respectively. A total of 80 infections (20.1%) occurred, among which, 14 infections were defined as severe. There was no significant difference in infection rate between patients with and without neutropenia (19.9%, 50/251 vs 20.3%, 50/251; χ(2) = 0.007, P = 0.933). There was no significant difference in infection rate between patients with and without peginterferon dose reduction (21.5%, 31/144 vs 19.2%, 49/255; χ(2) = 0.307, P = 0.580). In multivariate logistic regression analysis, the independent factors associated with infection were age (P = 0.021), diabetes (P = 0.004) and cirrhosis (P = 0.012).
Infections during treatment with peginterferon alfa and ribavirin for chronic hepatitis C are irrelevant to neutropenia. The independent factors associated with infection are age, diabetes and cirrhosis.
探讨聚乙二醇干扰素α联合利巴韦林治疗慢性丙型肝炎过程中中性粒细胞减少症（ANC）发生率与感染之间的相关性。
对哈尔滨医科大学附属第二医院传染病科数据库中399例接受聚乙二醇干扰素和利巴韦林治疗的患者进行回顾性队列研究。调查感染发生率及其与ANC的关系。通过多因素分析确定感染的潜在危险因素。
治疗期间，251例患者出现中性粒细胞减少症（ANC<1.50×10⁹/L）。其中，轻度中性粒细胞减少症[ANC：（>0.75-<1.50）×10⁹/L]、中度中性粒细胞减少症[ANC：（0.50-0.75）×10⁹/L]和重度中性粒细胞减少症（ANC<0.50×10⁹/L）分别发生在132例、103例和16例患者中。共发生80例感染（20.1%），其中14例感染被定义为严重感染。中性粒细胞减少症患者和未出现中性粒细胞减少症患者的感染率无显著差异（19.9%，50/251对20.3%，50/251；χ²=0.007，P=0.933）。聚乙二醇干扰素剂量降低患者和未降低患者的感染率无显著差异（21.5%，31/144对19.2%，49/255；χ²=0.307，P=0.580）。在多因素logistic回归分析中，与感染相关的独立因素为年龄（P=0.021）、糖尿病（P=0.004）和肝硬化（P=0.012）。
聚乙二醇干扰素α联合利巴韦林治疗慢性丙型肝炎过程中的感染与中性粒细胞减少症无关。与感染相关的独立因素为年龄、糖尿病和肝硬化。
