临床肝胆病杂志2013，Vol.29Issue(8)：603-606,4.DOI:10.3969/j.issn.1001-5256.2013.08.013
慢性乙型肝炎合并非酒精性脂肪性肝病患者抗病毒治疗的疗效探讨
Therapeutic effect of antiviral therapy in chronic hepatitis B patients with nonalcoholic fatty liver disease
摘要
Abstract
Objective To retrospectively analyze the therapeutic effect of antiviral therapy in the chronic hepatitis B (CHB) patients with nonalcoholic fatty liver disease (NAFLD) and to investigate whether hepatocyte steatosis affects the response to antiviraI therapy in CHB patients.Methods A total of 110 CHB patients and 99 CHB patients with NAFLD were enrolled in the study.Serum HBV DNA levels were measured by fluorescence quantitative PCR; serum HBsAg,HBsAb,HBeAg,HBeAb,and HBcAb were quantified by chemiluminescence;biochemical indices were determined by automatic biochemical analyzer to evaluate the liver function.Results (1) When receiving antiviral therapy with interferon,the CHB patients had a significantly higher rate of alanine aminotransferase (ALT)/aspartate aminotransferase (AST) normalization after 24 weeks of treatment (x2 =4.069,P =0.044) and a significantly higher rate of HBV DNA clearance after 48 weeks of treatment (x2 =17.327,P =0.000),as compared with the CHB patients with NAFLD; in all HBeAg-positive patients,those with only CHB had a significantly higher rate of ALT/AST normalization after 24 weeks of treatment (P ＜ 0.05) and significantly higher rates of HBV DNA clearance and HBeAg clearance after 24 and 48 weeks of treatment (P ＜ 0.05),as compared with those with CHB and NAFLD,but there was no significant difference in the rate of ALT/AST normalization between them after 48 weeks of treatment (P ＞ 0.05).(2) When receiving antiviral therapy with nucleos (t) ide analogues,the CHB patients had a significantly higher rate of ALT/AST normalization than the CHB patients with NAFLD after 48 weeks of treatment (x2-7.620,P =0.006),but there was no significant difference in the rate of HBV DNA clearance between them after 24 and 48 weeks of treatment (P ＞ 0.05) ; in all HBeAg-positive patients,those with CHB and NAFLD had a significantly higher rate of HBeAg clearance after 24 weeks of treatment (P ＜ 0.05) and a significantly lower rate of ALT/AST normalization after 48 weeks of treatment (P ＜ 0.05),as compared with those with only CHB,but there were no significant differences in the rate of ALT/AST normalization after 24 weeks of treatment,rates of HBV DNA clearance after 24 and 48 weeks of treatment,and rate of HBeAg clearance after 48 weeks of treatment between them (P ＞ 0.05).Conclusion To some extent,hepatocyte steatosis affects the response to antiviral therapy in CHB patients.关键词
肝炎,乙型,慢性/脂肪肝/抗病毒药Key words
hepatitis B, chronic / fatty liver/ antiviral agents分类
医药卫生引用本文复制引用
应若素,陈燕宇,卓丽,范慧敏,杨湛..慢性乙型肝炎合并非酒精性脂肪性肝病患者抗病毒治疗的疗效探讨[J].临床肝胆病杂志,2013,29(8):603-606,4.基金项目
2012年"光辉"慢性乙型肝炎科研基金项目(GHF2012206) （GHF2012206）
