摘要
目的回顾性分析常规剂量他汀类药物对既往有乙肝病毒(HBV)感染史的患者肝损害的影响,并探讨可能的机制。方法回顾性分析2005年10月—2008年09月江苏省人民医院心内科住院患者中服他汀类药物患者3125例,其中既往有HBV感染史174例,平均年龄66.60岁,男性131例;既往无HBV感染史166例,平均年龄65.81岁,男性131例,调查其服他汀后肝功能指标在短时期(2～15周)内的变化。比较两组的差异,分析出现差异的可能原因。结果丙氨酸转氨酶(ALT)升高大于正常上限(ULN)3倍而停药的比例,既往HBV感染组高于阴性组(2.87%比0.00%,χ2=0.1183,P=0.027),多因素回归分析示仅既往HBV感染史与服用他汀后ALT升高相关(β=11.77,sx珋=2.70,t=4.36,P=0.000)。结论既往有HBV感染史患者服用他汀类药物肝损害发生率增高,此类人群应加强肝功能监测。
Objective To study the presence of liver damage by statins in patients with history of hepatitis B virus infection.Methods Clinical data of 3125 inpatients from the Department of Cardiology,Jiangsu Provincial People＇s Hospital admitted between October 2005 to Septermber 2008 received statins therapy were retrospectively analyzed.Among the 3125 patients,174 patients had history of HBV infection（average age was 66.6 years and 131 patients were male） while 166 patients had no history of HBV infection in terms of all negative results on virus markers（average age was 65.8 years and 131 patients were male）.Changes in liver function test after 2-15 weeks of statins therapy compared with baseline were investigated.Results Patients in the two groups were matched for age,sex,comorbidities,smoking history,alcohol abuse,drug use,baseline liver and kidney function,blood lipids,profile blood glucose and the abnormal rates of AST or ALT before treatment.Higher percentage of patients in the HBV infection group showed ALT elevation 3 fold of ULN and required discontinuation of statins when compared with the non-infection group（2.87% vs.0.00%,χ2=0.1183,P=0.027）.Multivariate regression analysis identified history of HBV infection to be an independent risk of liver injury（β=11.77,sx=2.70,t=4.36,P=0.000）.Conclusion Statin therapy is associated with a higher risk of hepatotoxicity in patients with history of HBV infection.
出处
《中国介入心脏病学杂志》
2011年第4期223-226,共4页
Chinese Journal of Interventional Cardiology
