临床肝胆病杂志2017，Vol.33Issue(5)：849-852,4.DOI:10.3969/j.issn.1001-5256.2017.05.011
恩替卡韦治疗慢性乙型肝炎合并肝脂肪变的效果评价
Clinical effect of entecavir in treatment of chronic hepatitis B complicated by hepatic steatosis
摘要
Abstract
Objective To investigate the effect of antiviral therapy with entecavir in the treatment of chronic hepatitis B (CHB) complicated by hepatic steatosis.Methods A total of 164 HBeAg-positive CHB patients who visited Bazhou People's Hospital from June 2014 to June 2015 were enrolled,and according to the percentage of hepatocytes with steatosis in the hepatic lobules in all hepatocytes,they were divided into control group (＜ 5 ％ of hepatocytes with steatosis,89 patients),group A (5％-30％ of hepatocytes with steatosis,43 patients),and group B (＞ 30％ of hepatocytes with steatosis,32 patients).All patients were treated with entecavir.The serum virological parameters and liver function parameters were measured before treatment and at weeks 24 and 48 of treatment.A one-way analysis of variance was used for comparison of continuous data between groups,and the Bonferroni method was used for comparison between any two groups;the chi-square test was used for comparison of categorical data between groups.Results Hepatic steatosis did not affect the virologic response at week 24 of entecavir treatment (P ＞ 0.05).However at week 48 of entecavir treatment,compared with the control group,group B had significantly lower HBeAg clearance rate (34.4％ vs 60.2％,P =0.012) and HBV DNA clearance rate (40.6％ vs 67.4％,P =0.008).At weeks 24 and 48 of entecavir treatment,compared with the control group,groups A and B had a significantly lower alanine aminotransferase normalization rate than the control group (group A:P =0.013 and 0.001;group B:P =0.001 and P ＜ 0.001) and significantly higher levels of aspartate aminotransferase,alkaline phosphatase,and gamma-glutamyl transpeptidase (group A:P24 ＜ 0.001,P24 =0.031,and P24 =0.001,P48 ＜0.001,P48 =0.021,and P48 ＜0.001;group B:P24 ＜0.001,P24 =0.028,and P24 =0.001,P48 ＜0.001,P48 =0.017,P48 ＜0.001).Conclusion A percentage of hepatocytes with steatosis of ＞ 30％ is associated with the reduction in virologic response at week 48 of entecavir treatment.Hepatic steatosis affects the biochemical response in CHB patients at weeks 24 and 48 of entecavir treatment.关键词
肝炎,乙型,慢性/脂肪肝/恩替卡韦/治疗结果Key words
hepatitis B, chronic/fatty liver/entecavir/treatment outcome分类
医药卫生引用本文复制引用
吴艳琴,沈黎俊,于集虹,孙玉山..恩替卡韦治疗慢性乙型肝炎合并肝脂肪变的效果评价[J].临床肝胆病杂志,2017,33(5):849-852,4.基金项目
春雨工程感染科专项科研基金(2014-05) （2014-05）
