不同剂量干扰素α治疗慢性丙型肝炎疗效与安全性的系统评价_《中国循证医学杂志》

作者：

苏娜 , 吴逢波 ,  徐珽

四川大学华西医院药剂科（成都 610041）;

关键词：

干扰素α 慢性丙型肝炎剂量系统评价 Meta分析随机对照试验

DOI：

10.7507/1672-2531.20130036

视频：

导出 下载 收藏 扫码 引用

摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价不同剂量干扰素α治疗慢性丙型肝炎的疗效与安全性。
方法　计算机检索MEDLINE、EMbase、CENTRAL、CBM、CNKI、VIP和WanFang Data，查找有关不同剂量干扰素α治疗慢性丙型肝炎的随机对照试验，检索时限截至2012年8月。由2位研究者根据纳入与排除标准独立筛选文献、提取资料并评价质量后，采用RevMan 5.0软件进行Meta分析。
结果　最终纳入13个RCT，共1 442例患者。Meta分析结果显示：① 干扰素α 3 MU组与1 MU组治疗慢性丙型肝炎的完全应答率差异无统计学意义［RR=0.83，95%CI（0.52，1.32），P=0.43］，而两组持续应答率差异有统计学意义［RR=1.89，95%CI（1.00，3.59），P=0.05］；② 干扰素α 3 MU组与6 MU组以及10 MU组治疗慢性丙型肝炎的完全应答率和持续应答率差异均无统计学意义。
结论　干扰素α（治疗剂量3 MU，1周3次）治疗慢性丙型肝炎有效，但目前尚无证据确定是否存在剂量依赖效应。在使用干扰素α治疗慢性丙型肝炎时，应根据患者的耐受性和经济情况等实施个体化给药以有效控制慢性丙型肝炎。

引用本文： 苏娜,吴逢波,徐珽. 不同剂量干扰素α治疗慢性丙型肝炎疗效与安全性的系统评价. 中国循证医学杂志, 2013, 13(2): 210-217. doi: 10.7507/1672-2531.20130036 复制

1.	Koretz RL, Stone O, Gitnick GL. The long-term course of non A,non B post-transfusion hepatitis. Gastroenterology, 1980, 79(5 Pt 1): 893-898.
2.	Hartwell D, Shepherd J. Pegylated and non-pegylated interferon-alfa and ribavirin for the treatment of mild chronic hepatitis C: a systematic review and meta-analysis. Int J Technol Assess Health Care, 2009, 25(1): 56-62.
3.	Kjaergard LL, Krogsgaard K, Gluud C. Interferon alfa with or without ribavirin for chronic hepatitis C: systematic review of randomised trials. BMJ, 2001, 323(7322): 1151-1155.
4.	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from: www.cochrane-handbook.org.
5.	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0 [updated February 2008]. The Cochrane Collaboration, 2008.
6.	Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med, 2002, 21(11): 1539-1558.
7.	Hakozaki Y, Shirahama T, Katou M. A controlled study to determine the optimal dose regimen of interferon-alpha 2b in chronic hepatitis C. The American journal of gastroenterology, 1995, 90(8): 1246-1249.
8.	Bjoro K, Krarup H, Bell H. Two dose regimens of recombinant interferon-alpha-2b in chronic hepatitis C virus infection. Biochemistry, hepatitis C virus RNA, and liver histology as response indices. Scandinavian journal of gastroenterology, 1995, 30(11): 1119-1124.
9.	Tassopoulos NC, Karvountzis G, Touloumi G. Comparative efficacy of a high or low dose of interferon alpha 2b in chronic hepatitis C: a randomized controlled trial. The American Journal of Gastroenterology, 1996, 91(9): 1734-1738.
10.	Imai Y, Kawata S, Tamura S. Recombinant interferon-alpha-2a for treatment of chronic hepatitis C: results of a multicenter randomized controlled dose study. Liver, 1997, 17(2): 88-92.
11.	Ohmiya M, Hayashi J, Furusyo N. Large dose natural interferon alpha therapy for patients with chronic hepatitis C. Fukuoka Igaku Zasshi, 1997, 88(12): 380-388.
12.	Piccinino F, Felaco FM, Sagnelli E. Long-term lymphoblastoid interferon-alpha therapy for non-cirrhotic chronic hepatitis C: an Italian multicentre study on dose and duration of IFN alpha treatment. Research in Virology, 1998, 149(5): 283-291.
13.	姚光弼, 计焱焱. 两种剂量重组干扰素α2a治疗慢性丙型肝炎随机对照研究. 中华内科杂志, 1998, 37(2): 59-62.
14.	Matsumoto A, Tanaka E, Suzuki T. Viral and host factors that contribute to efficacy of interferon-a2a therapy in patients with chronic hepatitis C. Dig Dis Sci, 1994, 39(6): 1273-1280.
15.	Lin R, Roach E, Zimmerman M, et al. Interferon alfa-2b for chronic hepatitis C: effects of dose increment and duration of treatment on response rates. J Hepatol, 1995, 23(5): 487-496.
16.	Hagiwara H, Hayashi N, Mita E. Quantitative analysis of hepatitis C virus RNA in serum during interferon alfa therapy. Gastroenterology, 1993, 104(3): 877-883.
17.	Chemello L, Bonetti P, Cavalletto L. Randomized trial comparing three different regimens of alpha-2a-interferon in chronic hepatitis C. Hepatology, 1995, 22(3): 700-706.
18.	Marcellin P, Pouteau M, Martinot-Peignoux M. Lack of benefit of escalating dosage of interferon alfa in patients with chronic hepatitis C. Gastroenterology, 1995, 109(1): 156-165.
19.	Saracco G, Rosina F, Abate ML. Long term follow-up of patients with chronic hepatitis C Treated with different doses of interferon-a2b. Hepatology, 1993, 18(6): 1300-1305.
20.	谢尧, 徐道振. HCV基因型对慢性丙型肝炎干扰素疗效的影响. 中华肝脏病杂志, 2004,12(2): 72-75.
21.	金生, 周卫平. 丙型肝炎抗病毒治疗的影响因素及疗效预测. 中华肝脏病杂志, 2004, 12(2): 124-125.
22.	Fried MW, Hoofnagle JH. Therapy of hepatitis C. Semin Liver Dis, 1995, 15(1): 82-91.

1. Koretz RL, Stone O, Gitnick GL. The long-term course of non A,non B post-transfusion hepatitis. Gastroenterology, 1980, 79(5 Pt 1): 893-898.
2. Hartwell D, Shepherd J. Pegylated and non-pegylated interferon-alfa and ribavirin for the treatment of mild chronic hepatitis C: a systematic review and meta-analysis. Int J Technol Assess Health Care, 2009, 25(1): 56-62.
3. Kjaergard LL, Krogsgaard K, Gluud C. Interferon alfa with or without ribavirin for chronic hepatitis C: systematic review of randomised trials. BMJ, 2001, 323(7322): 1151-1155.
4. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from: www.cochrane-handbook.org.
5. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0 [updated February 2008]. The Cochrane Collaboration, 2008.
6. Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med, 2002, 21(11): 1539-1558.
7. Hakozaki Y, Shirahama T, Katou M. A controlled study to determine the optimal dose regimen of interferon-alpha 2b in chronic hepatitis C. The American journal of gastroenterology, 1995, 90(8): 1246-1249.
8. Bjoro K, Krarup H, Bell H. Two dose regimens of recombinant interferon-alpha-2b in chronic hepatitis C virus infection. Biochemistry, hepatitis C virus RNA, and liver histology as response indices. Scandinavian journal of gastroenterology, 1995, 30(11): 1119-1124.
9. Tassopoulos NC, Karvountzis G, Touloumi G. Comparative efficacy of a high or low dose of interferon alpha 2b in chronic hepatitis C: a randomized controlled trial. The American Journal of Gastroenterology, 1996, 91(9): 1734-1738.
10. Imai Y, Kawata S, Tamura S. Recombinant interferon-alpha-2a for treatment of chronic hepatitis C: results of a multicenter randomized controlled dose study. Liver, 1997, 17(2): 88-92.
11. Ohmiya M, Hayashi J, Furusyo N. Large dose natural interferon alpha therapy for patients with chronic hepatitis C. Fukuoka Igaku Zasshi, 1997, 88(12): 380-388.
12. Piccinino F, Felaco FM, Sagnelli E. Long-term lymphoblastoid interferon-alpha therapy for non-cirrhotic chronic hepatitis C: an Italian multicentre study on dose and duration of IFN alpha treatment. Research in Virology, 1998, 149(5): 283-291.
13. 姚光弼, 计焱焱. 两种剂量重组干扰素α2a治疗慢性丙型肝炎随机对照研究. 中华内科杂志, 1998, 37(2): 59-62.
14. Matsumoto A, Tanaka E, Suzuki T. Viral and host factors that contribute to efficacy of interferon-a2a therapy in patients with chronic hepatitis C. Dig Dis Sci, 1994, 39(6): 1273-1280.
15. Lin R, Roach E, Zimmerman M, et al. Interferon alfa-2b for chronic hepatitis C: effects of dose increment and duration of treatment on response rates. J Hepatol, 1995, 23(5): 487-496.
16. Hagiwara H, Hayashi N, Mita E. Quantitative analysis of hepatitis C virus RNA in serum during interferon alfa therapy. Gastroenterology, 1993, 104(3): 877-883.
17. Chemello L, Bonetti P, Cavalletto L. Randomized trial comparing three different regimens of alpha-2a-interferon in chronic hepatitis C. Hepatology, 1995, 22(3): 700-706.
18. Marcellin P, Pouteau M, Martinot-Peignoux M. Lack of benefit of escalating dosage of interferon alfa in patients with chronic hepatitis C. Gastroenterology, 1995, 109(1): 156-165.
19. Saracco G, Rosina F, Abate ML. Long term follow-up of patients with chronic hepatitis C Treated with different doses of interferon-a2b. Hepatology, 1993, 18(6): 1300-1305.
20. 谢尧, 徐道振. HCV基因型对慢性丙型肝炎干扰素疗效的影响. 中华肝脏病杂志, 2004,12(2): 72-75.
21. 金生, 周卫平. 丙型肝炎抗病毒治疗的影响因素及疗效预测. 中华肝脏病杂志, 2004, 12(2): 124-125.
22. Fried MW, Hoofnagle JH. Therapy of hepatitis C. Semin Liver Dis, 1995, 15(1): 82-91.

《中国循证医学杂志》

不同剂量干扰素α治疗慢性丙型肝炎疗效与安全性的系统评价

摘要 全文 图表 视频 参考文献 施引文献 补充材料

上一篇

下一篇

Format

Content

《中国循证医学杂志》

不同剂量干扰素α治疗慢性丙型肝炎疗效与安全性的系统评价

摘要 全文 图表 视频 参考文献 施引文献 补充材料

上一篇

下一篇

Format

Content

摘要全文图表视频参考文献施引文献补充材料