哪位高手能帮我翻译一下这篇英文,谢谢了。
TherearefewsatisfactorymedicaltreatmentsforpatientswhodonotachieveSVRinresponsetoIFN-...
There are few satisfactory medical treatments for patients who do not achieve SVR in response to IFN-based treatment.In such patients, the liver disease could progress to cirrhosis, hepatocellular carcinoma (HCC) and liver failure,culminating in liver disease-related death. Earlier retrospective cohort studies suggested that conventional IFN treatment reduces the risk of HCC even in patients who are treated with a single course as brief as 6 mo and who show transient biochemical response but fail to eradicate HCV[92-95]. In these non-randomized analyses, the shortorlong-term efficacy of conventional IFN or impact of the treatment outcome on the clinical end point were evaluated based on serum ALT levels, but not the degree of viral response because serum HCV RNA levels were not monitored. These studies included patients with various liver disease stages (degree of fibrosis) and perhaps those with SVR at a certain rate. The SVR induced by conventional IFN treatment apparently provides a longterm benefit by reducing liver-related death[96]. As shown by other retrospective cohort studies, it is conceivable that achievement of SVR following IFN-based treatment would reduce the risk of adverse clinical outcomes (liverrelated complications, HCC and liver-related mortality) even in patients with cirrhosis or advanced fibrosis, compared to non-SVR[97-99]. Furthermore, a small, prospective RCT suggested that even a single, brief (24-wk) course of conventional IFN treatment for patients with compensated cirrhosis (grade A on the Child-Pugh scoring system)could slow liver disease progression and reduce the cumulative incidence of HCC and mortality in the very longterm clinical course[100]. Another RCT of extended conventional IFN treatment to 30 mo showed suppression of HCV RNA levels and reduction in serum ALT levels and histologic findings (necroinflammation and fibrosis) in non-responders to 6-mo conventional IFN treatment but with a histologic response[101]. In that preliminary study,the majority of patients did not have advanced fibrosis or cirrhosis, and the impact of maintenance treatment on morbidity and mortality was not assessed. These favorable results encouraged clinicians to prevent progressive liver disease, including development of HCC and progression to cirrhosis and liver failure, with IFN-based maintenance treatment even in patients with advanced fibrosis or cirrhosis. However, most of the following prospective RCTs did not recommend long-term maintenance treatment for such patients.
要专业点的,网上直接翻译的就不要来了,谢谢合作
专业人士帮帮忙吧,谢谢了,急用啊! 展开
要专业点的,网上直接翻译的就不要来了,谢谢合作
专业人士帮帮忙吧,谢谢了,急用啊! 展开
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很少有令人满意的医学治疗的患者不达到SVR在回应IFN-based治疗。在这类病人,肝脏疾病才能进步肝硬化、肝细胞癌(HCC)和肝功能衰竭,最后在肝脏疾病相关的死亡。回顾性队列研究表明,早期治疗减少了常规使用干扰素方面的风险甚至肝癌患者治疗过程作为一个短暂的6个月出现生化学应答和瞬态,但未能清除丙型肝炎病毒(92 - 95)。在这些non-randomized的分析,结果shortorlong-term功效的常规使用干扰素方面或者影响的临床治疗结果进行评价终点血清ALT水平基础上,但不是因为病毒反应程度的血清丙型肝炎病毒RNA水平不是监控。这些研究涉及了各种肝病患者阶段(程度的纤维化)和也许按一定的比率与SVR。传统的SVR诱导治疗提供一个长期使用干扰素方面明显减少死亡效益研究[96]。如图所示其他回顾性队列研究,可想而知,成就后治疗IFN-based SVR减少风险的不良临床结果(liverrelated并发症、死亡率和研究肝癌)即使在肝硬化患者或先进的纤维化,比non-SVR[97 - 99]。此外,一个小的、前瞻性RCT建议即使一个单一的、短暂的(24-wk)课程传统使用干扰素方面治疗肝硬化患者补偿(等级评分系统在Child-Pugh)能够延缓疾病的进展和降低肝肝累计发生率和死亡率在非常长期的临床过程[100]。另一个RCT的扩展传统使用干扰素方面治疗丙型肝炎病毒的抑制30莫显示RNA水平和降低血清谷丙转氨酶和组织学表现(坏死性炎症和纤维化),治疗6个月non-responders常规使用干扰素方面,但有一个组织学反应[101]。在初步的研究中,大部分的病人没有先进的纤维化或肝硬化,在维持治疗的影响在发病率和死亡率没有评估。这些良好结果,鼓励防止进行性肝病临床医师,包括发展的肝细胞肝癌和肝硬化的进展和肝功能衰竭,甚至在IFN-based维持治疗末期病人纤维化或肝硬化。然而,最下面的潜在RCTs并不推荐治疗此类患者长期的维护。
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