基于索磷布韦的直接抗病毒药物治疗丙型肝炎肝硬化患者疗效评价
Efficacy of antiviral therapy based on sorfosbuvir combination in the treatment of patients with hepatitis C-induced liver cirrhosis
蔡峻岭 1苏立 1郝丽 1赵敏 1裴旭东2
作者信息
- 1. 463000 河南省驻马店市中心医院感染病科
- 2. 郑州大学附属南阳市中心医院感染性疾病科
- 折叠
摘要
目的 探讨基于索磷布韦(SOF)的直接抗病毒药物(DAAs)治疗代偿期丙型肝炎肝硬化(CHC-CLC)和失代偿期丙型肝炎肝硬化(CHC-DLC)患者的临床疗效.方法 2019年7月～2022年12月我科诊治的CHC-CLC患者39例和CHC-DLC患者23例,分别接受SOF联合维帕他韦(VEL)或在此联合方案的基础上加用利巴韦林治疗12 w.采用实时荧光定量RT-PCR法检测血清HCV RNA载量,采用基因分型芯片检测HCV基因型,常规检测血常规和血生化指标,计算天冬氨酸氨基转移酶(AST)和血小板(PLT)比值指数(APRI)和肝纤维化4因子指数(FIB-4),使用Fibroscan行肝硬度检测(LSM).结果 到治疗结束时,CHC-DLC患者死亡2例(8.7％);在生存患者中,CHC-CLC组治疗早期病毒学应答率、治疗结束应答率、持续病毒学应答率(SVR24)和SVR48分别为92.3％、100.0％、100.0％和100.0％,显著优于CHC-DLC组(分别为80.9％、100.0％、76.2％和66.7％,P＜0.05);治疗后,两组均获得病毒学应答,但CHC-CLC组血小板计数和白蛋白水平分别为(140.6±26.3)×109/L和(36.4±1.8)g/L,均显著高于CHC-DLC组[分别为(70.5±27.0)× 109/L 和(33.4±2.7)g/L,P＜0.05];CHC-CLC 组 APRI、FIB-4 和 LSM 分别为(1.1±0.4)、(3.0±1.0)和(13.8±2.0)kPa,均显著低于CHC-DLC组[分别为(1.7±0.7)、(5.1±1.7)和(26.2±2.5)kPa,P＜0.05].结论 基于SOF的DAAs治疗方案治疗CHC-CLC或CHC-DLC患者具有较为理想的病毒学应答率,肝功能指标得到改善,值得临床应用.
Abstract
Objective The aim of this study was to investigate clinical efficacy of antiviral therapy based on sorfosbuvir(SOF)combination in the treatment of patients with hepatitis C-induced liver cirrhosis(LC).Methods 39 patients with chronic hepatitis C-related compensated liver cirrhosis(CHC-CLC)and 23 patients with CHC-related decompensated liver cirrhosis(CHC-DLC)were encountered in our hospital between July 2019 and December 2022,and SOF and verapamil(VEL)combination was given in patients with CHC-CLC,and SOF and verapamil(VEL)combination plus ribavirin was given in patients with CHC-DLC for 12 weeks.Serum HCV RNA loads,biochemical index and routine blood cell counts were detected,and aspartate transaminase(AST)/platelet(PLT)ratio index(APRI)and fibrosis 4 score(FIB-4)were calculated.Liver stiffness measurement(LSM)was detected by Fibroscan.Results By end of treatment,two patients(8.7％)with CHC-DLC died;of survivals,early virologic response,end of treatment virologic response,sustained virologic response at 24 weeks(SVR 24)and SVR 48 in patients with CHC-CLC were 92.3％,100.0％,100.0％and 100.0％,all much superior to 80.9％,100.0％,76.2％and 66.7％(P＜0.05)in patients with CHC-DLC;by end of antiviral treatment,peripheral blood platelet count and serum albumin level in patients with CHC-CLC were(140.6±26.3)×109/L and(36.4±1.8)g/L,both significantly higher than[(70.5±27.0)×109/L and(33.4±2.7)g/L,respectively,P＜0.05]in patients with CHC-DLC;APRI,FIB-4 and LSM in patients with CHC-CLC were(1.1±0.4),(3.0±1.0)and(13.8±2.0)kPa,all significantly lower than[(1.7±0.7),(5.1± 1.7)and(26.2±2.5)kPa,respectively,P＜0.05]in patients with CHC-DLC.Conclusion DA As therapy based on SOF has an satisfactory virological response in patients with CHC-CLC or CHC-DLC,with improved biochemical parameters,while the long-term efficacy needs further clinical observation.
关键词
肝硬化/丙型肝炎/直接抗病毒药物/索磷布韦/肝纤维化/治疗Key words
Liver cirrhosis/Hepatitis C/Direct acting antivirals/Sophobovir/Liver fibrosis/Therapy引用本文复制引用
基金项目
河南省科技厅科技发展计划项目(222102310272)
出版年
2024
国家科技期刊平台
NSTL
维普
万方数据