小剂量聚乙二醇化干扰素联合利巴韦林治疗肝移植患者丙型肝炎复发不良反应研究1

摘要

Objective To observe the adverse effect and strategy of low dose pegylated-interferon (Peg-IFN) plus ribavirin (RBV) on patients with recurrent hepatitis C after liver transplantation. Methods The data of patients with recurrent hepatitis C after liver transplantation and treated with low dose Peg-IFN plus RBV were collected. The abnormality of routine blood test, function of liver and kidney, depression and alopecia were recorded. The clinical manifestation of depression and alopecia were recorded and treated properly. Results There were 22 cases who received low dose pegylated-interferon plus ribavirin treatment after liver transplantation. Among whom 22.7% (5/22) presented abnormal liver function, 68.2% (15/22) with granulocytopenia, 50% (11/22) with decreases of hemoglobin, 27.2% (6/22) with thrombocytopenia, 22.7%(5/22) with symptoms of irritability. One patient dropped out the study because of thrombocytopenia, the other 21 cases received the treatment for over 24 weeks. Conclusions Adverse events are common during the patients with recurrent hepatitis C after liver transplantation who received low dose Peg-IFN plus RBV treatment. Most of these adverse events are controllable. It is safe for patients with recurrent hepatitis C after liver transplantation to receive low dose Peg-IFN plus RBV treatment.%　　目的探讨小剂量聚乙二醇化干扰素（Peg-IFN）联合利巴韦林（RBV）治疗肝移植患者丙型肝炎复发疗程中的不良反应及应对措施。方法选择肝移植术后丙型肝炎复发且接受小剂量Peg-IFN和RBV治疗患者，检测患者血常规、肝肾功能，观察其临床表现及有无抑郁、脱发等不良反应并进行处理。结果术后行小剂量Peg-IFN联合RBV治疗丙型肝炎复发患者22例，治疗过程中出现肝功能异常者5例（22.7%）、粒细胞减少者15例（68.2%）、血红蛋白减少者11例（50%）、血小板减少者6例（27.2%）、易激惹症状者5例（22.7%）。22例患者中，有1例患者因血小板减少退出研究，其余21例患者均进行至少24周的抗丙型肝炎病毒治疗疗程。结论小剂量Peg-IFN联合RBV治疗肝移植术后丙型肝炎复发的不良反应普遍存在，但多数不良反应是可控的，两者联合治疗肝移植后丙型肝炎复发是安全的。