血清瘦素水平、胰岛素抵抗与慢性丙型肝炎抗病毒应答的相关性  

A virological response study of serum leptin level and insulin resistance on the antivirus effect in patients with chronic hepatitis C

作　　者：朱斌[1] 张平[1] 王昕红[1] 孙立华[1] 江之云[1] 

机构地区：[1]河南省新乡医学院第一附属医院感染疾病二科,453100

出　　处：《中华肝脏病杂志》2006年第12期887-889,共3页Chinese Journal of Hepatology

摘　　要：目的探讨血清瘦素水平、胰岛素抵抗与慢件丙型肝炎抗病毒持续病毒学应答(SVR)的相关性．评价血清瘦素水平、胰岛素抵抗是否为慢性丙型肝炎抗病毒SVR的独立危险因素。方法40例慢性丙型肝炎患者,接受干扰素α2a 5MU联合利巴韦林1．0g(0．8～1．2 g)抗病毒治疗24周,检测空腹血清瘦素、胰岛素、血糖、丙型肝炎病毒RNA、丙氨酸氨基转移酶、天冬氨酸氨基转移酶,计算胰岛素抵抗指数、体重指数,统计方法采用单因素相关分析和多因素逐步回归分析。结果40例丙型肝炎患者抗病毒治疗24周,随访6个月,获得SVR 23例,占57．5%,部分和无病毒学应答17例,占42．5%。获得SVR的患者较未获得SVR患者有较低的血清瘦素水平、胰岛素抵抗指数和体重指数(P＜0．01)。单变量分析SVR与年龄、丙型肝炎病毒RNA含量、血清瘦素水平、胰岛素抵抗相关,与性别、血清转氨酶无相关性．多变量逐步同归分析,血清瘦素、胰岛素抵抗是慢性丙型肝炎抗病毒治疗获得持续病毒学应答的独立预测因子。结论血清瘦素水平、胰岛素抵抗与慢性丙型肝炎抗病毒SVR相关,是SVR的独立预测因子。Objective To study the serum leptin level and insulin resistance on sustained virological response （SVR） in patients with chronic hepatitis C and to evaluate whether serum leptin level and insulin resistance are independent risk factors. Methods Forty chronic hepatitis C patients were treated with interferon （ α -2a） 5 MU and ribavirin 1.0 g for 24 weeks. The fasting serum leptin, insulin, glucose, HCV RNA load, alanine aminotransferase （ALT）, and aspartate aminotransferase （AST） were measured and the insulin resistance index （HOMA-IR： homeostasis model of assessment） and body mass index （BMI） were calculated. Statistical methods used were univariate analyses and multivariable regression analyses. Results Of the 40 patients, 23 patients （57.5%） had a sustained virological response and 17 patients （42.5%） had a non-sustained virological response. Patients with a sustained virological response had lower serum leptin, HOMA-IR and BMI. Their SVR was associated with age, HCV RNA loads, serum leptin level, and insulin resistanc% when analyzed with univariate analyses. SVR was not associated with sex, ALT, or AST. With multivariable regression analyses, serum leptin level and insulin resistance were found to be independent prediction factors for SVR in chronic hepatitis C patients with antivirus treatment. Conclusion Serum leptin level and insulin resistance were associated with SVR in chronic hepatitis C patients; they were independent prediction factors for SVR.

关 键 词：瘦素 胰岛素 肝炎 丙型 慢性 持续病毒学应答 

分 类 号：R512.63[医药卫生—内科学] R587.1[医药卫生—临床医学]