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目的探讨以应答为指导(RGT)的聚乙二醇干扰素α-2a联合利巴韦林(Peg-IFNα-2a+RBV)方案在基因6a型慢性丙型肝炎(CHC)中的效果。方法 2014年1月至2015年12月间连续入组基因6a型CHC患者共60例(优化组),接受Peg-IFNα-2a+RBV抗病毒治疗,其中达到快速病毒学应答(RVR)的患者疗程缩短至24周,未达到RVR者疗程为48周。同时以2012年1月至2013年12月期间,接受48周固定疗程的Peg-IFNα-2a+RBV治疗的所有基因6a型CHC患者为对照组(56例)。结果优化组患者快速病毒学应答(RVR)、治疗终点病毒学应答(ETR)、持续病毒性应答(SVR)、停药后复发发生率分别为67.2%、87.9%、82.8%和5.2%,与对照组的71.4%、82.1%、80.4%、1.8%比较,差异均无统计学意义(P>0.05)。优化组与对照组获得RVR患者的最终SVR率(92.3%vs 87.5%,),差异亦无统计学意义(P=0.479)。优化组除血象异常发生率低于对照组外,其他差异均无统计学意义。结论获得RVR的基因6a型CHC患者,其接受24周与48周疗程Peg-IFNα-2a+RBV治疗均能取得较高的SVR率。
Objective To investigate the effect of peginterferon alfa-2a combined with ribavirin (Peg-IFNα-2a + RBV) regimen in gene-type 6a chronic hepatitis C (CHC) guided by response. Methods A total of 60 patients (optimized group) with genotype 6a CHC were enrolled consecutively from January 2014 to December 2015 and were treated with Peg-IFNα-2a + RBV antiviral therapy. Patients with rapid virologic response (RVR) Shorten the course of treatment to 24 weeks, those who did not reach the RVR were treated for 48 weeks. Meanwhile, all patients with type 6a CHC treated with Peg-IFNα-2a + RBV for a 48-week fixed course from January 2012 to December 2013 were the control group (56 patients). Results In the optimized group, the rates of rapid virological response (RVR), end-of-treatment virological response (ETR), continuous viral response (SVR) and postoperative discontinuation were 67.2%, 87.9%, 82.8% and 5.2% The control group of 71.4%, 82.1%, 80.4%, 1.8%, the difference was not statistically significant (P> 0.05). The final SVR rate was 92.3% vs 87.5% in the RVR patients in the optimized and control groups, with no significant difference (P = 0.479). In the optimized group, the incidence of abnormalities of blood removal was lower than that of the control group, but the other differences were not statistically significant. CONCLUSIONS: RVC-type 6a patients with CHC who received Peg-IFNα-2a + RBV for 24 weeks and 48 weeks had a higher SVR rate.