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目的研究聚乙二醇化干扰素(PEG-IFNα-2a)联合利巴韦林(RBV)治疗慢性丙型肝炎(CHC)对肝纤维化的影响。方法选择65例CHC患者均给予PEG-IFNα180μg/周联合RBV 800~1000mg/d,疗程48周,观察HCVRNA、丙氨酸氨基转移酶(ALT)的变化,根据肝脏弹性测定(fibroScan,FS)结果,将肝脏纤维化分为F0~F4共五级,比较不同治疗阶段肝脏纤维化的变化。结果治疗后,FS值明显下降,治疗48周后HCVRNA阴转率58.46%,随访24周持续病毒学应答(SVR)率53.85%,与文献报道相符,ALT明显改善,与治疗前相比,差异有统计学意义,P<0.05。结论 PEG-IFNα-2a联合RBV治疗CHC可改善肝纤维化,有效降低ALT,抑制HCVRNA。FS具有准确、方便、可重复性强等优点,可用于CHC治疗过程中肝纤维化的监测。
Objective To investigate the effect of pegylated interferon (PEG-IFNα-2a) combined with ribavirin (RBV) on hepatic fibrosis in patients with chronic hepatitis C (CHC). Methods 65 patients with CHC were given PEG-IFNα180μg / week combined with RBV 800-1000mg / d for 48 weeks. The changes of HCV RNA and alanine aminotransferase (ALT) were observed. According to the results of fibroScan (FS) , The liver fibrosis is divided into F0 ~ F4 a total of five, compared with different stages of liver fibrosis changes. Results After treatment, the value of FS decreased significantly. After 48 weeks of treatment, the HCV RNA negative conversion rate was 58.46%, and the sustained virological response (SVR) rate was 53.85% at 24 weeks follow-up. Corresponding to the literature, ALT was significantly improved. There was statistical significance, P <0.05. Conclusions Treatment of CHC with PEG-IFNα-2a combined with RBV can improve hepatic fibrosis, reduce ALT and inhibit HCVRNA. FS has the advantages of accuracy, convenience and repeatability, which can be used for the monitoring of liver fibrosis during CHC treatment.