摘要
目的探讨慢性乙型肝炎(CHB)合并脂肪肝对聚乙二醇干扰素α-2a(PEG-IFNα-2a)临床疗效的影响。方法选择2006年6月-2012年6月于广西科技大学第一附属医院住院的CHB并脂肪肝患者248例,根据脂肪肝程度分为轻度组173例、中度组55例、重度组20例,分析脂肪肝的危险因素,观察3组患者12个月时的病毒学应答、生化学应答、完全应答情况。另选取同期单纯CHB患者82例作为对照组。结果 4组患者在男性构成比、年龄、CHO、TG、ALT、HBV DNA载量、BMI、胰岛素水平差异均有统计学意义(P均<0.05),而病程差异无统计学意义(P>0.05);CHB患者合并脂肪肝与患者性别、年龄、CHO、TG、ALT、HBV DNA载量、BMI、胰岛素水平密切相关(P<0.05);对照组患者HBV DNA转阴、病毒学应答与3个脂肪肝组差异无统计学意义(P>0.05),但ALT复常率、完全应答率明显高于3个脂肪肝组,且随着脂肪肝病变严重程度的增加而降低(P<0.05)。结论肝细胞脂肪病变不会影响PEG-IFNα-2a治疗CHB患者的病毒学应答,但会影响ALT复常率、完全应答率,在采用PEG-IFNα-2a治疗CHB过程中,采取相应的治疗措施提高患者ALT复常率及完全应答率,提高临床疗效,改善患者生存质量。
Objective To investigate clinical effects of PEG-IFNα-2a on chronic hepatitis B （CHB） complicated with fatty liver. Methods 248 patients with CHB complicated with fatty liver in the First Affiliated Hospital of Guangxi University of Science and Technology from Jun. 2006 to Jun. 2012 were selected and were divided into mild group （n = 173） , moderate group （n = 55） , severe group （n = 20） according to the grading fatty liver. Risk factors of fatty liver were analyzed. Virological response, biochemical response, complete response at 12 months in three groups were ob- served. In addition, 82 patients with CHB were selected as the control group. Results The patients＇ male ratio, age, CHO, TG, ALT, HBV DNA load, BMI, insulin levels in four groups had significant differences （P 〈 0.05） ; CHB with fatty liver was closely associated with gender, age, CHO, TG, ALT, HBV DNA load, BMI, insulin level （P 〈 0.05）. Compared with control group, there were no differences in HBV DNA negative, virological response in three fatty liver groups （P 〉 0.05） , but the ALT recovery rate, complete response rate were significantly higher in control group than those in three fatty liver groups, and with the increase of fatty liver disease severity, the ALT recovery rate and complete response rate were decreased （P 〈 0.05）. Conclusion Liver fatty lesion does not affect the virological response of PEG-IFNα-2a in treating patients with CHB, but will affect the ALT recovery rate, complete response rate. In treating CHB with PEG-IFNα-2a period, the corresponding treatment measures should be carried to improve recovery rate of ALT and complete response rate, to improve clinical efficacy and survival quality.
出处
《胃肠病学和肝病学杂志》
CAS
2014年第3期329-332,共4页
Chinese Journal of Gastroenterology and Hepatology
