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Clinical analysis of elderly patients with chronic hepatitis C
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摘要: 目的分析老年人慢性丙型肝炎的临床、生化及治疗疗效等特征。方法对2005年2月至2007年3月期间临床诊断慢性丙型肝炎的94例患者进行回顾性分析,比较老年（≥60岁）和中青年患者的一般资料、临床表现、生物化学、治疗疗效等特征。结果确诊慢性丙型肝炎时,51例老年患者的临床表现和中青年患者相似,老年组肝硬化的比例高于中青年组（39.2%对16.3%,P<0.01）,老年组血液白细胞及血小板计数均低于中青年组（P<0.01）,血清HCV RNA水平、肝功能指标和免疫学指标等差异无统计学意义。老年组中35.3%患者有聚乙二醇干扰素α-2b联合利巴韦林抗病毒治疗适应症明显低于中青年组的81.4%（P<0.01）,治疗过程中因不良反应减量或停止治疗的患者老年组有55.6%明显高于中青年组22.9%（P<0.05）。结论和中青年患者比较,老年慢性丙型肝炎患者并发症的发生率高、合并症多及联合抗病毒治疗耐受性差。Abstract: Objective To evaluate clinical features and treatment of chronic hepatitis C (CHC) in the aged patients.Methods Clinical data of 94 patients diagnosed with CHC were reviewed.Elderly patients (≥60 years) were compared in terms of clinical, biochemical, immunological features and treatment with younger patients (<60years) .Results Among the 94 patients.the initial diagnosis of CHC was made in 51 patients at an age≥60.The elder patients had similar clinical manifestations, except for higher liver cirrhosis ratio compared with younger patients (39.2% VS 16.3%, P<0.01) .The serum level of white blood cell and platelet count was lower in elderly patients compared with that of younger patients (P<0.01) , whereas there were no statistical differences in the serum HCV RNA levels, serum alanine aminotransferase, the serum total bilirubin and immunological findings between older and younger patients (P>0.05) .The ratio accommodate Peg-interferon alfa-2b plus ribavirin therapy lower in the elderly than in younger group (35.3% VS 81.4%, P<0.01) .among therapy Discontinuation or dose reduction was more frequent in older patients (P<0.05) .Conclusion Elderly patients have more complication compared with younger patients.They have lower tolerance with combination antiviral therapy.compared with younger patients.This suggests that we should diagnose and treat CHC early.
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Key words:
- Chronic hepatitis C /
- Elder
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[1]WHO consulation organized in collaboration with the viral hepatitisprevention board.Global surveillance and control of hepatitis C[J].J Viral Hepat, 1999, 6∶35-47. [2]Manns MP, McHutchison JG, Gordon SC, et al.Peg-interferon al-fa-2b plus ribavirin compared to interferon alfa-2b plus ribavirinfor the treatment of chronic hepatitis C.A randomized trial[J].Lan-cet, 2001, 358 (9286) ∶958-965. [3]Fried MW, Shiffman ML, Reddy KR, et al.Peg-interferon alfa-2a plus ribavirin for chronic hepatitis C infection[J].NEngl J Med, 2002, 347 (13) ∶975-982. [4] 中华医学会.丙型肝炎防治指南[J].中华内科杂志, 2004, 43∶551-555. [5]Shiratori Y, Imazeki F, Moriyama M, et al.Histological improve-ment of fibrosis in patient with hepatitis C who have sustained re-sponse to interferon therapy[J].Ann Intern Med, 2000, 132∶517-524. [6]Yoshida H, Shiratori Y, Moriyama M, et al.Interferon therapy re-duces the risk for hepatocellular carcinoma development:nature sur-veillance program of cirrhotic and noncirrhotic patients with chronichepatitis C in Japan[J].Ann Intern Med, 1999, 131∶174-181. [7]Imai Y, Kasahara A, Tanaka H, et al.Interferon therapy for agedpatients with chronic hepatitis C:improved survival in patients exhib-iting a biochemical response[J].J Gastroenterol, 2004, 39∶1069-1077. [8]Yoshida H, Arakawa Y, Sata M, et al.Interferon therapy prolongedlife expectancy among chronic hepatitis C patients[J].Gastroenterol-ogy, 2002, 123∶483-491. [9]McHutchison JG, Gordon SC, Schiff ER, et al.Interferon alfa-2balone or in combination with ribavirin as initial treatment for chronichepatitis C.Hepatitis Interventional Therapy Group[J].N Engl JMed, 1998, 339∶1485-1492. [10]Sulkowski MS, Wasserman R, Brooks L, et al.Changes in haemo-globin during interferon alpha-2b plus ribavirin combination therapyfor chronic hepatitis C virus infection[J].J Viral Hepat, 2004, 11∶243-250. -
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