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目的:观察聚乙二醇干扰素α-2b联合利巴韦林治疗血友病合并慢性丙型肝炎的疗效及安全性。方法:血友病合并慢性丙型肝炎患者52例分为两组,治疗组29例患者予聚乙二醇干扰素α-2b联合利巴韦林,对照组23例患者予重组人干扰素α-2b联合利巴韦林,观察病毒学应答、白细胞、血小板数量变化及出血情况。结果:治疗组患者快速病毒学应答(RVR)、早期病毒学应答(EVR)、治疗结束时病毒学应答(ETVR)、第24周时持续病毒学应答(SVR24)、分别为57.1%、64.2%、64.2%、57.1%。对照组患者RVR、EVR、ETVR、SVR24分别为54.5%、68.2%、63.6%、54.5%,两组比较差异无统计学意义(P>0.05)。不良反应中,治疗组白细胞下降、血小板下降、出血发生率、严重出血发生率分别为68.9%、24.1%、51.7%、3.4%,对照组为65.2%、26.1%、56.5%、4.3%,治疗组白细胞下降、血小板下降、出血发生率、严重出血发生率与对照组相当,两组比较差异无统计学意义(P>0.05)。结论:对于血友病合并慢性丙型肝炎患者,聚乙二醇干扰素α-2b联合利巴韦林与普通干扰素α-2b联合利巴韦林治疗的疗效和安全性相当,但需要严密监控患者出血情况,并及时处理。
Objective: To observe the efficacy and safety of pegylated interferon α-2b combined with ribavirin in the treatment of hemophilia combined with chronic hepatitis C Methods: Fifty-two patients with hemophilia and chronic hepatitis C were divided into two groups: 29 patients in the treatment group received pegylated interferon alfa-2b combined with ribavirin, and 23 patients in the control group received recombinant interferon-α -2b combined ribavirin, observed virological response, white blood cells, platelet count changes and bleeding. RESULTS: The rapid virologic response (RVR), early virological response (EVR), end of treatment response (ETVR), and virologic response at week 24 (SVR24) were 57.1%, 64.2% , 64.2%, 57.1%. The RVR, EVR, ETVR and SVR24 in the control group were 54.5%, 68.2%, 63.6% and 54.5% respectively. There was no significant difference between the two groups (P> 0.05). Adverse reactions, the treatment group leukopenia, thrombocytopenia, bleeding, severe bleeding were 68.9%, 24.1%, 51.7%, 3.4%, 65.2% in the control group, 26.1%, 56.5%, 4.3% Group leukopenia, thrombocytopenia, the incidence of bleeding, the incidence of severe bleeding and the control group, the difference between the two groups was not statistically significant (P> 0.05). Conclusions: The efficacy and safety of peginterferon alfa-2b combined with ribavirin and interferon alfa-2b plus ribavirin are similar for patients with hemophilia and chronic hepatitis C, but require close Monitoring patient bleeding, and timely treatment.