Segmentation

1
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2
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• 80??? ???????????
• ????????????
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3
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• ???????????????
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4
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5
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6
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??HCV 60 to 85
?? 15 to 40
??? 10 to 15
?? 85 to 90
HCC,????? 25 (2 to 4)
???? 75

• ?????????????,??10??20??????????????9.20?15.29
  

NIH Management of Hepatitis C Consensus
Conference Statement. June 10-12, 2002. Available
at http//consensus.nih.gov/2002/2002HepatitisC20
02116html. Accessed April 10, 2007.
7
????????10????????
2000?????10????????
8
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• ?????
• ???????3 ??
• ????????6??
• ?????????20???10 ,????30???20
• 14??

9
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???????????????
10
???????????

• ????(?HCV)
• ????(HCV-RNA)
• ??????
• B???
• ?????

11
?????????

• ????????????,6????,????????
• ????????,?????
• ?????,????
• ????,??????????,??????,?????????????????

12
????(HCV RNA)??

• HCV RNA????(????????)
• ??HCV???????HCV RNA??????
• HCV RNA??????????(98??),????????????????HCV??
• ?????????????HCV??,?????
• HCV RNA???? (???x10n)
• HCV???????????????????????????,???????????????????
  ???

13
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??1?
???1?

• ??????????????????????????
• ????1???,???????????,??????????
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14
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???????
? ?????????????
???????????(??????)1,2
?????1
???????????????????????????????????????????3
1. NIH Consensus Statement Online. Management of
hepatitis C. 2. British Liver Trust Information
Service. A guide to liver function tests. 3.
????????
15
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16
????????

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• ???????????????????????????
• ???????????????????

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17
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• ???????????
• (???????24?,????????)
• ????
• ?????????

18
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• ????,????????????????
• ????,????????????
• ??????????,??????
• ????????????????
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• ????????

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19
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???????? (???????) ??????
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20
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75
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70
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61
60
50
41
PEG???(???)???????SVR??60??
SVR ()
40
30
20
10
0
??????? 2002?
??? ???? 1998 ?1,2
??? ???? 2002 ?5,6
1. McHutchison JG et al. N Engl J Med.
19983391485-1492. 2. Poynard T et al. Lancet.
19983521426-1432. 3. Zeuzem S et al. N Engl J
Med. 20003431666-1672. 4. Lindsay KL et al.
Hepatology. 200134395-403. 5. Manns MP et al.
Lancet. 2001358958-965. 6. Hadziyannis SJ.
EASL Annual Meeting. 2002.
21
????????????

• PEG???(???)
• ????
• ????
• ????????
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• ?????
• ?????????
• ??????(38??)
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• ?????????????

22
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• ????,???????????????????
• ??????????????????????
• ??????????????
• ?????????????????????

23
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• ?????????????????
• ?????????????????,??????,???????
• ???????????????????????????,????????
• ???HCV RNA??,???HCV???

24
????????????

• ?????????
• ???????????????????????
• ????????????????24?????????
• ?????????
• ?????????(????? 24 ?)????????????(HAI)??(Knodell?
  ???2)?? 2 ?
• ??????
• ??????????????????
• ???????????? ,????????????
• ?????????,???????????????

25
??????????

• ???? ??
• ???1
• ??????(?? / ???)
• ???

• ???? ?? / ??
• ??????????1
• ??????????2
• ????????
• ?????????2
• ????????

??????,????????????????????????
1. Worman HJ. Hepatitis C current treatment. 2.
Peters MG et al. Medscape HIV/AIDS eJournal.
20028(1). 3. Nishiguchi S et al. Lancet.
19953461051-1055.
26
?????????????????
100 80 60 40 20 0
????
?????
72
70
?????? ( ??)
????????????,???????a-2a????????24?48??????????,??
??48????????24???
52
30
0
0
???(N69)
??48?(N210)
??24?(N212)
????A vs C Plt001B vs CPlt001B vs
APlt001(Odds Ratio 3.13)
S Zeuzem et al. Gastroenterology 2004