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聚乙二醇干扰素联合利巴韦林治疗后获得持续病毒学应答的中国丙型肝炎相关肝硬化患者的良好结局

Favorable Outcomes of Chinese HCV-Related Cirrhotic Patients with Sustained Virological Response after Pegylated Interferon Plus Ribavirin Treatment.

作者信息

Zhang Geng-Lin, Chen You-Ming, Zhang Ting, Cai Qing-Xian, Zhang Xiao-Hong, Zhao Zhi-Xing, Lin Chao-Shuang, Gao Zhi-Liang

机构信息

Department of Infectious Diseases, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China; Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

Department of Infectious Diseases, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

出版信息

Biomed Res Int. 2017;2017:8061091. doi: 10.1155/2017/8061091. Epub 2017 Jan 23.

Abstract

Few studies have conducted follow-up investigations of the clinical course in HCV-related cirrhotic patients who achieved a sustained virological response (SVR) with pegylated interferon plus ribavirin treatment (PegIFN + RBV). We investigated the clinical course and laboratory data in a prospective cohort study enrolling HCV-related cirrhotic patients who received PegIFN + RBV between August 2008 and July 2013 in China. Complete blood counts, liver function tests, and HCV-RNA were serially examined. Liver-related complications were recorded. To detect hepatocellular carcinoma (HCC), alpha-fetoprotein assays, and ultrasound scans were repeated at 6-month intervals. Twenty-five patients were enrolled, including 8 patients with decompensation events before treatment. Eighteen patients achieved SVR with a mean follow-up period of 25.78 months. During the follow-up period, only one patient exhibited HCV-RNA positivity and no decompensation events were detected, but 4 patients developed HCC after SVR. APRI decreased more in patients with SVR than in patients with non-SVR (median, -1.33 versus 0.86, < 0.001). The albumin levels and platelet counts significantly increased during the follow-up period after SVR (44.27 ± 4.09 versus 42.63 ± 4.37, = 0.037 and 173.89 ± 87.36 versus 160.11 ± 77.97, = 0.047). These data indicated that HCV-related cirrhotic patients with SVR after PegIFN + RBV may have a favorable clinical course and improvements in laboratory data. Moreover, HCC should be monitored.

摘要

很少有研究对接受聚乙二醇干扰素联合利巴韦林治疗(PegIFN + RBV)并实现持续病毒学应答(SVR)的丙型肝炎病毒(HCV)相关肝硬化患者的临床病程进行随访调查。我们在中国进行了一项前瞻性队列研究,调查了2008年8月至2013年7月期间接受PegIFN + RBV治疗的HCV相关肝硬化患者的临床病程和实验室数据。连续检测全血细胞计数、肝功能检查和HCV-RNA。记录肝脏相关并发症。为了检测肝细胞癌(HCC),每隔6个月重复进行甲胎蛋白检测和超声扫描。共纳入25例患者,其中8例在治疗前发生失代偿事件。18例患者实现了SVR,平均随访期为25.78个月。在随访期间,只有1例患者HCV-RNA呈阳性,未检测到失代偿事件,但4例患者在SVR后发生了HCC。与未实现SVR的患者相比,实现SVR的患者APRI下降幅度更大(中位数,-1.33对0.86,<0.001)。SVR后随访期间白蛋白水平和血小板计数显著升高(44.27±4.09对42.63±4.37,P = 0.037;173.89±87.36对160.11±77.97,P = 0.047)。这些数据表明,接受PegIFN + RBV治疗后实现SVR的HCV相关肝硬化患者可能有良好的临床病程,实验室数据也有所改善。此外,应监测HCC。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3743/5292367/31480004d175/BMRI2017-8061091.001.jpg

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