| ObjectiveIn this study we aim at comparing the efficacy and safety of DAAs combined treatment and PEG-IFN+RBV in patients with hepatitis C cirrhosis,and observing the effects of DAAs on liver function and indexes of liver fibrosis,predicting the promotion factors of SVR,and providing the basis for clinical treatment of patients with hepatitis C cirrhosis.Participants and MethodsWe selected 99 patients who were diagnosed with hepatitis C cirrhosis,all patients were from the third People's Hospital of Taiyuan between2015.01.01-2016.01.01.We classified the patients into groups,patients accepting SOF+LDV and SOF+DCV therapy as study group,accepting PEG-IFN+RBV therapy as control group.Collecting laboratory examination results comprehensively.Chi-square test ? independent-samples T test and unconditional logistic regression analysis were used for data processing with the statistical software of SPSS 16.0,and P<0.05 was considered statistically significant.Results1?The SVR24 rates of SOF+DCV group and SOF+LDV group were 93.5% and94.7% respectively,the rate of SVR24 in group IFN+RBV was only 35.3%.The SVR24 rates in SOF+DCV group and SOF+LDV group were significantly higher than that in group IFN+RBV.2?Patients of SOF+DCV and SOF+LDV groups were well tolerated,adverse reactions during the treatment of the two groups were 28.3% and 26.3%,the most common adverse events were fatigue,headache and nausea,no significant adverse events were observed.The incidence rate of IFN+RBV group was 91.2%,which was significantly higher than that of DAAs groups(P<0.001)?3 ? The ALT value of IFN+RBV group showed a decreasing trend with the prolongation of treatment time,and there was statistical significance in the difference between different periods of treatment and before treatment(P<0.05),after 4 weeks of treatment,the value of was significantly higher than that at the end of the 2 week;the value of AST was lower than that before treatment at the end of the 2 week and P<0.05;ALB after treatment 2 and 4 weeks,compared with before treatment,and after the end of treatment compared with before treatment?2 weeks and 4 weeks,the value of the former was higher,P<0.05;the value of TBIL was increased after 2 and 4 weeks treatment,P<0.05.4?The values of ALT,AST and TBIL in the SOF+DCV group and SOF+LDV group decreased with the prolongation of treatment time,and the differences between the different periods of treatment and the prophase were statistically significant(P<0.05);Values were higher than those before treatment at 2 weeks,and after the treatment at the end of treatment,and the ALB values were higher than those at the end of treatment,compared with those at 4 weeks after treatment.5 ? IFN+RBV group PCIII after treatment was lower than before the treatment,P=0.002;SOF+DCV group PCIII and HA after treatment was lower than before the treatment,the difference was statistically significant,P values were 0.043,0.026;PCIII?HA and LN in SOF+LDV group after treatment decreased compared with before treatment,P values were 0.036?0.048 and 0.010.6?SOF+DCV group of initial treatent and treat-experienced patients with SVR24 rate were 93% and 94%,SVR24 rates of compensatory group and decompensated group were 95% and 89%,there were no significant differences(P=0.893 and0.534);group SOF+LDV of initial treatent and treat-experienced patients with SVR24 were 100% and 92%,SVR24 rates of compensatory group and decompensated group were 93% and 100%,there were no significant differences(P=0.497 and 0.402).7?The OR values of ALB?PLT and TBIL were 2.74,2.08 and 0.66 respectively.Conclusion1?In the treatment of patients with hepatitis C cirrhosis,DAAs combination therapy has better efficacy and higher safety than PEG-IFN+RBV.2?DAAs can significantly improve the liver function in patients with hepatitis C cirrhosis.3?Initial treatent and treat-experienced patients,compensated and decompensa-ted hepatitis C cirrhosis,SVR24 has no significant difference.4?ALB>35g/L,PLT >100×109,TBIL<21 mol/L may be the protection factors of SVR24 in SOF+DCV program. |
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