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慢性丙型肝炎患者对人淋巴母细胞干扰素反应的预测因素的统计分析。

A statistical analysis of predictive factors of response to human lymphoblastoid interferon in patients with chronic hepatitis C.

作者信息

Hayashi J, Ohmiya M, Kishihara Y, Tani Y, Kinukawa N, Ikematsu H, Kashiwagi S

机构信息

Department of General Medicine, Kyushu University Hospital, Fukuoka, Japan.

出版信息

Am J Gastroenterol. 1994 Dec;89(12):2151-6.

PMID:7977232
Abstract

OBJECTIVE

To determine markers predictive of effective interferon treatment for patients with chronic hepatitis C virus (HCV) infection, we studied 80 Japanese patients treated for 6 months with natural interferon-alpha.

METHODS

Serum samples were tested for HCV RNA by two-stage polymerase chain reaction (PCR). HCV RNA were grouped into four genotypes by amplification of core-gene sequences by PCR with type-specific primers, and the level of HCV RNA was measured by competitive PCR. HCV RNA was detected in all patients before the interferon treatment. For the purposes of this study, a complete response was defined as the elimination of HCV RNA for at least 6 months after termination of the treatment.

RESULTS

HCV RNA was eliminated from the sera of 27 patients (33.8%) at the termination of the interferon treatment, and the elimination was sustained throughout a 6-month follow-up (complete response). Four of eleven variables proved to be associated with a complete response when assessed by univariate analysis. With multiple logistic regression analysis assessment, however, only two variables (HCV RNA level (p < 0.001) and genotype (p = 0.048)) were significant.

CONCLUSION

These results suggest that factors associated with the HCV infection are more important than patient characteristics for effective interferon treatment of patients with chronic HCV infection and that a low level of HCV RNA and HCV of genotype III are useful predictors of a complete response.

摘要

目的

为了确定预测慢性丙型肝炎病毒(HCV)感染患者干扰素治疗有效的标志物,我们对80例接受天然α干扰素治疗6个月的日本患者进行了研究。

方法

采用两阶段聚合酶链反应(PCR)检测血清样本中的HCV RNA。通过使用型特异性引物的PCR扩增核心基因序列,将HCV RNA分为四种基因型,并通过竞争性PCR测量HCV RNA水平。所有患者在干扰素治疗前均检测到HCV RNA。在本研究中,完全缓解定义为治疗终止后至少6个月内HCV RNA清除。

结果

干扰素治疗结束时,27例患者(33.8%)血清中的HCV RNA被清除,且在6个月的随访期间清除持续存在(完全缓解)。单因素分析评估时,11个变量中有4个与完全缓解相关。然而,通过多因素逻辑回归分析评估,只有两个变量(HCV RNA水平(p < 0.001)和基因型(p = 0.048))具有显著性。

结论

这些结果表明,对于慢性HCV感染患者的有效干扰素治疗,与HCV感染相关的因素比患者特征更重要,并且低水平的HCV RNA和III型HCV是完全缓解的有用预测指标。

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