基因1b型慢性丙型肝炎不同抗病毒药物治疗方式的临床治疗效果分析

摘要/Abstract

摘要： 目的探讨应用不同抗病毒药物治疗方式对基因1b型慢性丙型肝炎(CHC)的疗效及安全性的影响。方法回顾性分析2021年1月至2024年12月期间三亚市人民医院收治的155例基因型1b型CHC患者的临床资料。根据治疗方案的不同,将患者分为来迪派韦/索磷布韦(LDV/SOF)组、索磷布韦/维帕他韦(SOF/VEL)组与聚乙二醇干扰素α-2b注射剂/利巴韦林(PR)组。对比各组患者治疗前后的肝功能与血常规指标水平,并比较两组患者治疗4周、12周及疗程结束后12周的病毒学应答率。结果治疗结束后,LDV/SOF组和SOF/VEL组患者的血清天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)分别为[(34.9±6.7) U/L、 (31.6±5.9) U/L]和[(35.1±6.3) U/L、(32.7±4.2) U/L],明显低于PR组,分别为 [(48.4±5.9) U/L、 (44.7±4.8) U/L],差异均有统计学意义(均P<0.05);LDV/SOF组和SOF/VEL组的白细胞(WBC)和血小板计数(PLT)分别为[(6.4±1.2) ×10⁹/L、 (206.5±30.1) ×10⁹/L]与[(6.3±1.4) ×10⁹/L、(208.7±32.7) ×10⁹/L],明显高于PR组,分别为 [(3.6±1.1) ×10⁹/L、(135.4±35.2) ×10⁹/L](均P<0.05)。LDV/SOF组在治疗4周、12周以及治疗结束后12周的病毒学应答率分别为87.30%、95.24%和93.65%,SOF/VEL组分别为79.63%、96.30%和92.59%,均显著高于PR组的63.16%、73.68%和71.05%(均P<0.05)。在治疗期间,LDV/SOF组和SOF/VEL组的不良反应率分别为15.87%和14.81%,明显低于PR组的63.16%,差异均具有统计学意义(均P<0.05)。结论根据患者的病情,应用直接抗病毒药物方案治疗基因1b型CHC患者,病毒学应答率高,疗效好,肝功能改善显著,且安全性良好。

关键词: 慢性丙型肝炎, 基因1b型, 直接抗病毒药物, 疗效

Abstract: Objective To investigate the efficacy and safety of different antiviral treatment regimens for chronic hepatitis C (CHC) patients with hepatitis C virus (HCV) genotype 1b infection. Methods A retrospective analysis was conducted on the clinical data of 155 CHC patients with HCV genotype 1b infection admitted to Sanya People′s Hospital from January 2021 to December 2024. All patients were divided into three groups based on different treatment regimens they received: a ledipasvir/sofosbuvir (LDV/SOF) group, a sofosbuvir/velpatasvir (SOF/VEL) group, and a peginterferon α-2b injection/ribavirin (PR) group. The levels of serological liver function and blood routine test indicators were compared before and after treatment in each group, and the virological response rates at 4 weeks, 12 weeks, and 12 weeks after the end of treatment were also compared between the two groups. Results After treatment, the levels of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the LDV/SOF and SOF/VEL groups were [(34.9±6.7)U/L, (31.6±5.9)U/L] and [(35.1±6.3)U/L, (32.7±4.2)U/L], respectively, which were significantly lower than those in the PR group [(48.4±5.9)U/L, (44.7±4.8)U/L] (both P<0.05). The white blood cell (WBC) and platelet count (PLT) levels in the LDV/SOF and SOF/VEL groups were [(6.4±1.2)×10⁹/L, (206.5±30.1)×10⁹/L] and [(6.3±1.4)×10⁹/L, (208.7±32.7)×10⁹/L], respectively, which were significantly higher than those in the PR group [(3.6±1.1)×10⁹/L, (135.4±35.2)×10⁹/L] (both P<0.05). The virological response rates at 4 weeks, 12 weeks, and 12 weeks after the end of treatment in the LDV/SOF and SOF/VEL groups were 87.30%, 95.24%, and 93.65%, respectively, which were significantly higher than those in the PR group (63.16%, 73.68%, and 71.05%, respectively) (both P<0.05). During treatment, the adverse reaction rates in the LDV/SOF and SOF/VEL groups were 15.87% and 14.81%, respectively, which were significantly lower than that in the PR group (63.16%) (both P<0.05). Conclusion The application of direct antiviral drug regimens according to the condition of CHC patients with HCV genotype 1b infection results in high virological response rates, good efficacy, significant improvement in liver function, and good safety.

Key words: Chronic hepatitis C, Genotype 1b, Direct-acting antiviral drugs, Efficacy

黄卉, 彭玉凤. 基因1b型慢性丙型肝炎不同抗病毒药物治疗方式的临床治疗效果分析[J]. 肝脏, 2026, 31(5): 639-642.

HUANG Hui, PENG Yu-feng. An analysis on the clinical efficacies of different antiviral treatment approaches for chronic hepatitis C patients with hepatitis C virus genotype 1b infection[J]. Chinese Hepatolgy, 2026, 31(5): 639-642.

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