目的: 探究直接作用抗病毒药物（direct-acting antivirals,DAAs）对慢性丙型肝炎患者肝肾功能及血常规相关检测指标的变化,以评估 DAAs 对丙型肝炎患者肝肾功能及血常规的影响。方法: 本次研究在 2015 年 1 月—2018 年 12 月期间在句容市人民医院收治的 107 例接受 DAAs 治疗的丙肝患者资料,对每位患者进行一对一的问卷调查,并收集治疗开始前及治疗完成后的肝肾功能和血常规相关的检测指标的变化情况,分析其治疗前后各指标改变情况。结果: 在接受 DAAs 治疗后,丙肝患者的肝功能指标如谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素、直接胆红素、碱性磷酸酶和谷氨酰转肽酶均有明显改善（P<0.05）,且在不同性别分层中结果基本一致;其中,ALT 的异常率从 64.15% 降至3.77%,AST 的异常率从 66.98% 降至 5.66%,谷氨酰转肽酶的异常率从 51.92% 降至 15.38%;此外,DAAs 对血常规指标的影响较小,虽有部分指标如单核细胞百分率、中性粒细胞计数、平均血小板体积、血小板分布宽度和血小板计数等指标在治疗前后有差异,但改变均处于正常值范围内。结论: DAAs 可显著改善丙肝患者的肝功能,且未发现对肾功能和血常规指标的不良影响,值得在中国汉族丙型肝炎患者中推广使用。
Abstract
Objective: To explore the changes of liver and kidney function and blood routine in patients with chronic hepatitis C before and after treatment with direct acting antivirals (DAAs), so as to evaluate its influence on liver and kidney function and blood routine parameters of chronic hepatitis C patients. Methods: 107 patients with hepatitis C who received DAAs in Jurong Hospital Affiliated to Jiangsu University from January 2015 to December 2018 were enrolled to conduct a one-to-one questionnaire survey to every patient. Information about liver and kidney function and blood routine before and after treatment were also collected and the changes of each indicator were analyzed. Result: After DAAs treatment, liver function indicators such as ALT, AST, total bilirubin, direct bilirubin, alkaline phosphatase and glutamyltranspeptidase were significantly improved in HCV patients (P<0.05), and the results were basically consistent in each gender stratification. The abnormal rate of ALT decreased from 64.15% to 3.77%, AST from 66.98% to 5.66%, and glutamyltranspeptidase from 51.92% to 15.38%. In addition, some blood routine indicators such as monocyte ratio, neutrophil count, mean platelet volume, platelet distribution width and platelet count were different in the two groups before and after treatment, but the changes were within the normal value range. Conclusion: DAAs can significantly improve liver function in hepatitis C patients, and no adverse effects were found on renal function and blood routine indicators. So, they are worthy of popularization in hepatitis C patients of the Han nationality.
关键词
慢性丙型肝炎 /
直接抗病毒药物（DAAs） /
肝肾功能 /
血常规
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Key words
chronic hepatitis C /
DAA /
liver and kidney function /
blood routine
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参考文献
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脚注
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基金
*1镇江市重点研发计划（社会发展）项目（编号：SH2019035,SH2018058）; 句容市民生科技计划项目（编号：SF2018453282）
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