中文摘要：

目的研究抗病毒药物治疗时间及剂量对慢性丙型肝炎患者治疗效果的影响。方法选择2010年6月至2014年4月接受治疗的慢性丙型肝炎患者90例。所有患者均采用聚乙二醇干扰素联合利巴韦林治疗,血红蛋白均降至100 g/L。将其按随机数表法随机分为两组,严格组（n=45）和放宽组（n=45）,严格组当血红蛋白≤100 g/L时减量,血红蛋白≤80 g/L时停药;放宽组当血红蛋白≤80 g/L时减量,血红蛋白≤60/L时停药。观察两组患者的持续病毒学应答（SVR）、复发率、总胆红素（TBil）、天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、γ-谷氨酰氨基转移酶（γ-GT）等指标和不良反应。结果两组患者在治疗结束停药后随访观察6个月,放宽组患者的SVR明显高于严格组,复发率低于严格组,TBil、AST、ALT和γ-GT与严格组患者相比均有所下降,差异均有统计学意义（P〈0.05）。两组患者在治疗过程中均出现多种不良反应,但两组患者的不良反应种类及发生率比较差异无统计学意义（P〉0.05）。结论对于采用聚乙二醇干扰素联合利巴韦林治疗的慢性丙型肝炎患者,放宽利巴韦林剂量调整可以提高患者的SVR,降低患者的复发率,患者的肝脏指标有所改善,并未增加患者的不良反应,值得在临床推广应用。

英文摘要：

Objective To study the treatment effect of antiviral treatment time and dose in patients with chronic hepatitis C.Methods Ninety patients with chronic hepatitis C treated in our hospital from June 2010 to April 2014 with polyethylene glycol interferon（ PEG-IFN） plus ribavirin,were randomly divided into group A（ n = 45） and group B（ n = 45）.Patients in group A received reduced dose when hemoglobin was≤100 g/L,and stopped medicine when hemoglobin was ≤80 g/L; patients in group B received reduced dose until hemoglobin was ≤80 g/L,and stopped medicine until hemoglobin was ≤60 g / L.Observed two-group patients with sustained virological response（ SVR）,recurrence rate,total bilirubin（ TBil）,aspartate transaminase（ AST）,benzene alanine transaminase（ ALT）,gamma-glutamyltransferase（ γ-GT） and other indicators and adverse reactions.Results All patients were followed for 6 months after the drug was stopped at the end of the treatment.Compared with patients in group A,the SVR was higher,recurrence rate was lower,TBil,AST,ALT and γ-GT were decreased in group B（ all P 0.05）.A variety of adverse reactions were observed in both groups in the treatment process,but no difference was found in the incidence and types of adverse reactions between two groups（ P0.05）.Conclusion Easing ribavirin dose adjustment can improve SVR,reduce recurrence rate and improve hepatic index,but does not increase adverse reactions in chronic hepatitis C patients treated with PEG-IFN plus ribavirin.