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目的探讨慢性丙型肝炎(CHC)标准化抗病毒治疗应答的影响因素,为临床提供参考价值。方法选择97例CHC患者,分别检测丙型肝炎病毒(HCV)基因型、HCV RNA和白细胞介素-28B(IL-28B)位点rs8099917基因型。患者均接受标准化抗病毒治疗。分析获得快速病毒学应答(RVR)、早期病毒学应答(EVR)、治疗结束时病毒学应答(ETVR)和持续病毒学应答(SVR)的影响因素。结果 HCV基因1型组和非1型组、rs8099917基因TT型组和GT+GG型组的RVR、EVR、ETVR和SVR差异具均有统计学意义(χ2=9.359、11.440、6.346、8.147、9.938、7.413、4.564和4.229,P<0.05)。获得RVR的独立影响因素为HCV基因非1型、高ALT和AST水平、低HCV RNA载量以及rs8099917基因TT型;获得EVR的独立影响因素为HCV基因非1型和低HCV RNA载量;获得ETVR的独立影响因素为高ALT水平;获得SVR的独立影响因素为HCV基因非1型、高ALT水平和rs8099917基因TT型。结论 HCV基因非1型、高ALT水平和rs8099917基因TT型是获得SVR的有利因素。
Objective To investigate the influencing factors of response to standardized antiviral therapy in patients with chronic hepatitis C (CHC) and provide reference value for clinical practice. Methods Ninety-seven CHC patients were selected and the HCV genotypes, HCV RNA and rs8099917 genotypes of interleukin-28B (IL-28B) were detected. Patients received standardized antiviral therapy. Factors influencing rapid virological response (RVR), early virological response (EVR), virological response (ETVR) at the end of treatment, and sustained virologic response (SVR) were analyzed. Results There were significant differences in RVR, EVR, ETVR and SVR between HCV genotype 1 and non-genotype 1 rs8099917 genotype TT genotype and GT genotype GG genotype (χ2 = 9.359,11.440,6.346,8.147,9.938 , 7.413, 4.564 and 4.229, P <0.05). Independent factors influencing RVR were HCV genotype 1, high ALT and AST levels, low HCV RNA load and rs8099917 TT genotype. The independent factors influencing EVR were HCV genotype 1 and low HCV RNA load. The independent influencing factors of ETVR were high ALT level. The independent influencing factors of SVR were HCV genotype 1, high ALT level and rs8099917 TT genotype. Conclusion The non-type 1, high ALT level of HCV gene and TT genotype of rs8099917 gene are favorable factors for obtaining SVR.