中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

利巴韦林联合聚乙二醇干扰素α治疗慢性丙型肝炎发生相关溶血性贫血的影响因素分析

徐金凤 张晓慧 柳雅立 张晶

引用本文:
Citation:

利巴韦林联合聚乙二醇干扰素α治疗慢性丙型肝炎发生相关溶血性贫血的影响因素分析

DOI: 10.3969/j.issn.1001-5256.2019.02.015
详细信息
  • 中图分类号: R512.63

Influencing factors for hemolytic anemia in patients with chronic hepatitis C treated by ribavirin combined with pegylated interferon-α

  • 摘要:

    目的本研究利用干扰素队列探讨慢性丙型肝炎治疗过程中利巴韦林(RBV)引起溶血性贫血的影响因素,为临床早期预测RBV相关溶血性贫血发生提供借鉴。方法选取2016年3月-2018年3月于北京佑安医院门诊及住院的慢性丙型肝炎且应用PEG-IFNα联合RBV方案抗病毒治疗患者235例,并在抗病毒治疗前进行血常规、肝功能、肝脏硬度值、HCV RNA、HCV病毒基因型及三磷酸肌苷焦磷酸酶(ITPA)基因型检测,在2、4、8、12周对患者进行血常规检测。符合正态分布的计量资料组间比较采用t检验,不符合正态分布的计量资料组间比较采用Mann-Whitney U检验;计数资料组间比较采用X2检验或Fisher确切概率法。RBV相关溶血性贫血发生的影响因素采用单因素和多因素logistic回归分析,并据此建立预测模型,采用受试者工作特征曲线分析该模型对RBV相关溶血性贫血的预测价值。结果 2、4、8、12周时ITPA(rs1127354)基因型CC组Hb下降程度显著大于AA+AC组(P值均<0.>30 g/L比例(2. 3...

     

  • [1]European Association for the Study of the Liver.EASL clinical practice guidelines:Management of chronic hepatitis B virus infection[J].J Hepatol, 2012, 57 (1) :167-185.
    [2]Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association.The guideline of prevention and treatment for hepatitis C:A 2015 update[J].JClin Hepatol, 2015, 31 (12) :1961-1979. (in Chinese) 中华医学会肝病学分会, 中华医学会感染病学分会.丙型肝炎防治指南 (2015年更新版) [J].临床肝胆病杂志, 2015, 31 (12) :1961-1979.
    [3]LI Y, LIU L, LUO SL, et al.Association of direct-acting antiviral therapy for hepatitis C with the development and recurrence of liver cancer[J].J Clin Hepatol, 2018, 34 (2) :410-413. (in Chinese) 李砚, 刘蕾, 罗书兰, 等.丙型肝炎直接抗病毒治疗与肝癌发生及复发的关系[J].临床肝胆病杂志, 2018, 34 (2) :410-413.
    [4]GAETA GB, PRECONE DF, FELACO FM, et al.Premature discontinuation of interferon plus ribavirin for adverse effects:A multicentre survey in'real world'patients with chronic hepatitis C[J].Aliment Pharmacol Ther, 2002, 16 (9) :1633-1639.
    [5]FELLAY J, THOMPSON AJ, GE D, et al.ITPA gene variants protect against anaemia in patients treated for chronic hepatitis C[J].Nature, 2010, 464 (7287) :405-408.
    [6]LIU Z, WANG S, QI W, et al.The relationship between ITPArs1127354 polymorphisms and efficacy of antiviral treatment in Northeast Chinese CHC patients[J].Medicine (Baltimore) , 2017, 96 (29) :e7554.
    [7]OCHI H, MAEKAWA T, ABE H, et al.ITPA polymorphism affects ribavirin-induced anemia and outcomes of therapy-a genome-wide study of Japanese HCV virus patients[J].Gastroenterology, 2010, 139 (4) :1190-1197.
    [8]WANG ML, PAN Y, JIANG J, et al.Association between ITPAgene variation and anemia during treatment with interferon combined with ribavirin[J].Chin J Gerontol, 2013, 33 (12) :2759-2761. (in Chinese) 王茉莉, 潘煜, 姜晶, 等.ITPA基因变异与干扰素联合利巴韦林治疗过程中发生贫血的相关性[J].中国老年学杂志, 2013, 33 (12) :2759-2761.
    [9]HOLMES JA, ROBERTS SK, ALI RJ, et al.ITPA genotype protects against anemia during peginterferon and ribavirin therapy but does not influence virological response[J].Hepatology, 2014, 59 (6) :2152-2160.
    [10]THOMPSON AJ, FELLAY J, PATEL K, et al.Variants in the IT-PA gene protect against ribavirin-induced hemolytic anemia and decrease the need for ribavirin dose reduction[J].Gastroenterology, 2010, 139 (4) :1181-1189.
    [11]DENG HH, XU M, LI XQ, et al.Correlation of inosine triphosphate pyrophosphatase single nucleotide polymorphism and ribavirin-related anemia in patients with chronic hepatitis C in Guangzhou[J/CD].Chin J Exp Clin Infect Dis:Electronic E-dition, 2017, 11 (2) :168-171. (in Chinese) 邓浩辉, 许敏, 李晓强, 等.广州地区丙型肝炎患者肌苷三磷酸酶基因多态性与利巴韦林所致贫血的相关性[J/CD].中华实验和临床感染病杂志:电子版, 2017, 11 (2) :168-171.
    [12]VAN VLIERBERGH H, deLANGHE JR, de VOS M, et al.Factors influencing ribavirin-induced hemolysis[J].J Hepatol, 2001, 34 (6) :911-916.
    [13]NOMURA H, TANIMOTO H, KAJIWARA E, et al.Factors contributing to ribavirin-induced anemia[J].J Gastroenterol Hepatol, 2004, 19 (11) :1312-1317.
    [14]TAKAKI S, TSUBOTA A, HOSAKA T, et al.Factors contributing to ribavirin dose reduction due to anemia during interferon alfa2b and ribavirin combination therapy for chronic hepatitis C[J].J Gastroenterol, 2004, 39 (7) :668-673.
  • 加载中
计量
  • 文章访问数:  1562
  • HTML全文浏览量:  37
  • PDF下载量:  296
  • 被引次数: 0
出版历程
  • 出版日期:  2019-02-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回