| Purpose:Study on PEG-IFN α-2a and ribavirin combined with ursodeoxycholic acid inpatients with chronic hepatitis C treatment.Method:selected80patients with chronic hepatitis C patients in the Department of internalmedicine of China-Japan Union Hospital of Jilin University since2010September. Thediagnosis with the Chinese Medical Association in2004the infectious disease andparasitic society, Hepatology, jointly developed the " hepatitis C prevention guide " inthe diagnostic standard. All the patients were divided into2groups:groupPEG-IFN+RBV+UDCA group PEG-IFN+RBV. No statistically significant differencesbetween age and sex of the patients in the2groups (P>0.05). Before treatment,2groups of liver function and Child-Pugh were no significant difference (P>0.05). Showthat the two groups of patients age, gender and liver function damage degreecomparable. Application of PEG-IFNa-2a in all patients180μg, once a week,subcutaneous injection, combined with oral ribavirin (RBV)800-1200m/d. The courseof treatment was48weeks,24weeks follow-up. The PEG-IFN+RBV+UDCA groupwere treated with ursodeoxycholic acid10mg/kg body weight/day. Treatment according to the tolerance of Peg-IFNa-2a and ribavirin to adjust the dosage orwithdrawal. All patients take routine blood test, liver function, blood fat, blood glucose,three hepatitis B, HCV antibody, quantitative of HCV-RNA, type of HCV-RNA,autoimmune antibodies, thyroid function and liver, spleen ultrasound. ELASA methodwas used to detect HCV serological markers; the Beckman automatic biochemicalanalyzer was used to detect serum biochemical indexes; by using the method offluorescence quantitative PCR in detection of serum HCVRNA quantification; usingPCR-microplate hybridization-ELASA method to detect HCV-RNA genotype.Resuilt(1) The investigation of80cases of chronic viral hepatitis C antiviral treatmentof patients, including male49cases, female31cases, male and female ratio was1.58:l,average age41.52+7.39years old.(2) The PEG-IFN+RBV+UDCA group and thePEG-IFN+RBV group in the anti-viral treatment had no significant difference between(3) In the course of treatment in PEG-IFN+RBV+UDCA group compared withPEG-IFN+RBV group, the liver function were improved obviously. ALT, AST, GGT inthe treatment of late especially after discontinuation of interferon were improved, andTBIL in the treatment of early stage is obviously improved compared with thePEG-IFN+RBV group.(4) In the course of treatment,37cases in thePEG-IFN+RBV+UDCA group patients with autoimmune antibody was positive in6cases (16..21%);43cases in the PEG-IFN+RBV group appeared autoimmune antibody positive in14cases (32.56%). Hypothyroidism occurred in1patients duringthe treatment of experimental group (2.7%), the PEG-IFN+RBV group during thetreatment of complicated autoimmune disease in3cases (6.98%), including2cases ofhypothyroidism,1cases of diabetes mellitus.(5) Compared several side effects ofinterferon, the PEG-IFN+RBV+UDCA group and the PEG-IFN+RBV group in thefatigue, muscle aches, fever, bone marrow suppression, thyroid dysfunction and so on,found that bone marrow suppression situation appears less in experimental group, therewas statistical significance.(6)As of the end of the48week, in groupPEG-IFN+RBV+UDCA, interferon cumulative dose was8356.78±502.36μ g wassignificantly higher than that in PEG-IFN+RBV group,7665.34±489.65μ g, bettertolerated antiviral therapy.Conclusion：(1) Ursodeoxycholic acid for the treatment of chronic hepatitis C can be reducedwhen the autoimmune phenomenon, may have a role in immune regulation.(2)Ursodeoxycholic acid for the treatment of chronic hepatitis C, though not improveantiviral treatment response rate, but can improve the liver function, reduce side effectsof interferon induced inhibition of bone marrow, so as to improve the tolerance ofantiviral therapy in patients with. |
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