Dragomiretskaya Natalia, Izha Anna, Kalinichenko Nikolay, Szark-Eckardt Mirosława, Klimczyk Mariusz, Cieślicka Mirosława, Muszkieta Radosław, Prusik Krzysztof, Napierała Marek, Żukowska Hanna, Zukow Walery
Ukrainian scientific research institute of medical rehabilitation and curortology Ministry of Health Ukraine, Odessa, Ukraine.
Faculty of Physical Culture, Health and Tourism, Kazimierz Wielki University, Bydgoszcz, Poland.
Open Med (Wars). 2015 Mar 20;10(1):209-215. doi: 10.1515/med-2015-0032. eCollection 2015.
The presence of background HCV infection cannot be overestimated in view of the prevalence of chronic hepatitis C and the risk of adverse outcomes of this disease. Purpose of this study was to evaluate the effectiveness of the combined use of antiviral therapy (Roferon + Vero-Ribavirin) and resort factors in patients with chronic hepatitis C in the phase of replication.
We observed 48 patients with chronic hepatitis C; the minimum level of activity of the process defined the phase of replication. Markers of HCV infection were determined by enzyme linked immunosorbent assay (ELISA) (a-HCV and HCV-Ig M). HCV RNA was determined twice by the polymerase chain reaction (PCR). Genotyping of hepatitis C virus was performed. Biochemical blood analysis and the study of HCV infection markers were carried out four times. Results of therapy were assessed immediately after the end of the resort (spa) treatment, then at 3, 6 and 12 months after starting treatment. At 12 months after starting treatment, all the observed patients had persistent clinical and biochemical remission. Elimination of the virus from the blood was noted in 56% of the control group and 74% of patients in the study group.
For patients with moderately active HCV, the replication phase was characterized by asthenic-vegetative syndrome (100% of patients) with severe depression (22.92%), pain (77.08%) and dyspeptic syndrome (33.33%), moderate hypertransferaseemia (100%), slightly pronounced cholestasis (33% of patients), and signs of mesenchymal-inflammatory response.
鉴于慢性丙型肝炎的患病率以及该疾病不良后果的风险,背景丙型肝炎病毒(HCV)感染的存在不容小觑。本研究的目的是评估抗病毒治疗(罗扰素+维洛-利巴韦林)与疗养因素联合使用对处于复制期的慢性丙型肝炎患者的有效性。
我们观察了48例慢性丙型肝炎患者;疾病活动的最低水平确定为复制期。通过酶联免疫吸附测定(ELISA)(抗-HCV和HCV-IgM)检测HCV感染标志物。通过聚合酶链反应(PCR)对HCV RNA进行两次检测。进行丙型肝炎病毒基因分型。血液生化分析和HCV感染标志物研究进行了4次。在疗养(温泉)治疗结束后立即评估治疗结果,然后在开始治疗后的3、6和12个月进行评估。在开始治疗后的12个月,所有观察患者均有持续的临床和生化缓解。对照组56%的患者和研究组74%的患者血液中病毒被清除。
对于HCV中度活跃的患者,复制期的特征为虚弱-植物神经综合征(100%的患者),伴有严重抑郁(22.92%)、疼痛(77.08%)和消化不良综合征(33.33%)、中度转氨酶血症(100%)、轻度胆汁淤积(33%的患者)以及间质性炎症反应迹象。