生存质量分析在干扰素治疗慢性丙型肝炎疗效评价中的应用

摘要

Objective To investigate the significance of quality of life ( QOL) assessment on the efficacy evaluation of different types of interferon in the treatment of chronic hepatitis C ( CHC ) . Methods 140 patients accorded with the inclusion and exclusion criteria and with educational level higher than junior high school level were included in the study, who were admitted into the Kuancheng Manzu Autonomous County Hospital from February 2011 to May 2014. According to IFN types, the subjects were divided into two groups: group A ( n =62 ) and group B ( n =78 ) . Group A was administrated with Peg IFNα-2a combined with ribavirin, and group B was administrated with IFNα-2b combined with ribavirin. The HCV -RNA level, HCV genotype and virological response of the two groups were tested, and CLDQ assessment was conducted. Results The two groups were not significantly different ( P>0. 05 ) in HCV RNA level. The two groups were not significantly different ( P>0. 05) in the HCV RNA level of patients with different genotypes. Group A was higher (P <0. 05) than group B in RVR and EVR; the two groups were not significantly different (P>0. 05) in SVR. Group A was higher (P<0. 05) than group B in RVR and EVR of non genotype -1b patients. Group A was higher ( P <0. 05 ) than group B in FA score. The two groups were significantly different (P<0. 05) in the EF, SS and WO scores of genotype 1b patients. Group A was lower (P<0. 05) than group B in the AC, EF, SS and WO scores of non genotype -1b patients. Conclusion The introduction of quality of life assessment in the comprehensive efficacy evaluation of different types of INF in the treatment of CHC showed that the IFNα-2b is more effective. IFNα-2b combined with ribavirin may be a priority for non genotype-1b patients.%目的：探讨生存质量( QOL)分析在不同类型干扰素( INF)治疗慢性丙型肝炎( CHC)疗效评价中的意义。方法收集2011年2月—2014年5月于宽城满族自治县医院住院，符合纳入与排除标准且文化程度均为初中以上的患者140例。根据使用IFN类型分为A组(62例)、 B组(78例)。 A组给予聚乙二醇干扰素α(Peg IFNα)2a联合利巴韦林治疗， B组给予干扰素α-2b (IFNα-2b)联合利巴韦林治疗。检测两组患者丙型肝炎病毒(HCV) RNA水平及HCV基因型、病毒学应答情况，并进行慢性肝病特异性量表( CLDQ)评分。结果两组患者HCV RNA水平比较，差异无统计学意义( P>0．05)。两组不同基因型患者HCV RNA水平比较，差异无统计学意义( P>0．05)。 A组快速病毒学应答(RVR)、早期病毒学应答(EVR)高于B组(P<0．05)；两组持续病毒学应答(SVR)比较，差异无统计学意义(P>0．05)。 A组非1b基因型患者的RVR、 EVR高于B组(P<0．05)。 A组疲劳(FA)评分高于B组(P<0．05)。两组1b基因型患者的情感(EF)、系统症状(SS)、焦虑度(WO)评分比较，差异有统计学意义(P<0．05)。 A组非1b基因型患者的活动能力(AC)、 EF、 SS、 WO评分低于B组(P<0．05)。结论引入QOL分析对不同类型INF治疗CHC患者的疗效进行综合评价， IFNα-2b的疗效优势更显著，非1b基因型患者或可优先选择IFNα-2b联合利巴韦林治疗。