聚乙二醇干扰素对慢性丙型肝炎患儿生长和身体组成的影响：一项儿童丙型肝炎研究（PEDS-C）实验结果
背景：关注儿童干扰素治疗与其体重减少和增长的变化。目的：前瞻性研究儿童丙型肝炎治疗期间和之后体重，身高，体重指数和身体成分的变化。方法：用聚乙二醇干扰素α（2a） +/-利巴韦林治疗丙型肝炎患儿的PEDS-C实验，在其期间和之后进行人体测量，DXA扫描，饮食和活动评估。随机入组114名儿童（ 55％为男性） ，平均年龄11±3岁，其中107名儿童接受至少24周的治疗。将受试者根据治疗时间分为3组 ：24（N= 14），48（n =82）或72（n =11）周。各组在治疗期间，观察到体重，身高和体重指数，最大下降0.50 z分数（与基线相比，P≤0.01）。在48周治疗组，29名受试者（33％） HFA Z分数下降大于0.5单位。虽然HFA和BMI z分数在停止治疗后返回到基线，但是平均HAZ分数是缓慢回升的，仍低于长期治疗组别在治疗后96周的基线水平（P=0.03），同时低于大部份治疗48周患儿的基线。患儿身体脂肪百分比，脂肪质量和三头肌皮褶厚度Z分数在治疗期间逐渐下降。膳食能量摄入和体力活动水平在治疗过程中没有改变。结论：儿童体重，线性增长，身体质量指数和身体成分的显著变化与聚乙二醇干扰素α（2a）治疗有关。这些影响在停止治疗后一般可逆的，尽管大部分患儿的HFA Z分数在观察2年后未回到基线。慢性丙型肝炎治疗的儿童中需要更多的长期观察数据。
吉林大学第一医院肝胆胰内科 于鸽 摘译
本文首次发表于[Hepatology ，2012 Mar 2]
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Peginterferon for chronic hepatitis C in children affects growth and body composition: Results from the pediatric study of hepatitis C (PEDS-C) Trial.
Abstract
Background：Weight loss and changes in growth are noted in children treated with interferonα
Objectives：To prospectively determine changes in weight, height, body mass index and body composition during and after treatment of children with hepatitis C.
Methods：Children treated with PEG-IFNα(2a) +/- ribavirin in the PEDS-C trial underwent anthropometric measurements, DXA scan, dietary and activity assessments during and after treatment. 114 (55% male) children mean age 11±3 years were randomized, and 107 received treatment for at least 24 weeks. Subjects were divided into 3 groups according to duration of treatment: 24 (N=14), 48 (N=82), or 72 (N=11) weeks.Decrements of up to 0.50 z score were observed for weight, height and BMI while on therapy among all groups (P≤0.01 compared to baseline). In the group treated for 48 weeks, 29 (33%) subjects had greater than 0.5 unit decrement in height-for-age Z score.While weight-for-age and BMI z scores returned to baseline after cessation of therapy, mean HAZ score was slower to rebound, still lower than baseline at 96 weeks post-therapy for the long treatment duration group (P=0.03) and lower than baseline in most children treated for 48 weeks.Percent body fat, fat-free mass z scores and triceps skinfold z scores decreased with therapy. Dietary energy intake and levels of physical activity did not change during treatment.
Conclusions：PEG-IFNα(2a) was associated with significant changes in body weight, linear growth, body mass index and body composition in children. These effects were generally reversible with cessation of therapy, although height-for-age z scores had not returned to baseline after 2 years of observation in many. Longer term growth data are needed among children treated for chronic HCV.
