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可接受聚乙二醇化干扰素α-2a(40KD)加利巴韦林16周简化疗程的丙肝病毒基因型2/3患者的识别
Identifying Hepatitis C Virus Genotype 2/3 Patients Who Can Receive a 16-Week Abbreviated Course of Peginterferon Alfa-2a (40KD) Plus Ribavirin
Diago M, Shiffman ML, Bronowicki J-P  2010/7/9 14:05:06 
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Hepatology, 2010,
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The objective of this analysis was to compare sustained virological response (SVR) and relapse rates in patients with a rapid virological response (RVR, HCV RNA <50IU/mL at week 4) randomized to 24 or 16 weeks of treatment with peginterferon alfa-2a (40KD) 180μg/week plus ribavirin 800mg/day in the multinational ACCELERATE study. The analysis was restricted to patients who received treatment for 80% or more of the planned duration. Of 1309 eligible patients, 863 individuals (65.9%) achieved an RVR and were included in this analysis (458 assigned to 16 weeks and 405 assigned to 24 weeks). The overall SVR rate was significantly higher in patients randomized to 24 weeks of treatment (91% versus 82%; P=0.0006) and among patients infected with genotype 2 (92% versus 81%; P=0.0010) but not genotype 3 (90% versus 84%; P=0.1308). Relapse rates were significantly lower among all patients randomized to 24 weeks of treatment: overall (6% versus 15%, P<0.0001); in those infected with genotype 2 (5% versus 17%, P=0.0001), and genotype 3 (7% versus 14%, P=0.0489). SVR rates in patients with a vira l load of 400,000IU/mL or less randomized to 24 and 16 weeks of treatment were similar, 95% and 91% (P=0.2012). Significant pretreatment predictors of SVR included assignment to 24 weeks of treatment (P=0.0006), absence of advanced fibrosis on liver biopsy (P=0.0032), lower HCV RNA level (P=0.0017), and lower body weight (P<0.0001).
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病例分析 <span class="ModTitle_Intro_Right" id="EPMI_Home_MedicalCases_Intro_div" onclick="javascript:window.location='http://www.elseviermed.cn/tabid/127/Default.aspx'" onmouseover="javascript:document.getElementById('EPMI_Home_MedicalCases_Intro_div').style.cursor='pointer';document.getElementById('EPMI_Home_MedicalCases_Intro_div').style.textDecoration='underline';" onmouseout="javascript:document.getElementById('EPMI_Home_MedicalCases_Intro_div').style.textDecoration='none';">[栏目介绍]</span>  病例分析 [栏目介绍]
甲状腺功能亢进合并黄疸

 王燕燕 王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。
 

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