宿主和病毒因素在慢性乙型肝炎肝细胞脂肪变中的作用  

Viral and host causes of hepatosteatosis in chinese patients with chronic hepatitis B

作　　者：施军平[1] 范建高[1] 武瑞[1] 高晓倩[1] 张莉[1] 

机构地区：[1]杭州市第六人民医院,310014

出　　处：《中华实验和临床病毒学杂志》2008年第5期324-326,共3页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的探讨宿主和病毒因素在慢性乙型肝炎（CHB）患者肝细胞脂肪变中的作用。方法将肝穿组织活检证实的562例CHB患者（男450例，女112例），分为肝脂肪变组（102例）和无脂肪变组（460例），比较两组的人口学特征、病毒学指标和生化学指标。结果在562例CHB患者中，102例（18．15％）有不同程度肝细胞脂肪变；男性高于女性。肝脂肪变组患者BNI（体重指数）、血清TG（甘油三酯）、Cho（总胆固醇）、UA（尿酸）、FSG（空腹血糖）水平和超重，肥胖、糖尿病、血脂异常和高尿酸血症患病率以及饮酒习惯者比例显著高于无肝脂肪变组（P〈0．01）。多元回归分析显示：BMI、TG、UA与CHB患者肝脂肪变的发生密切相关。结论CHB患者肝细胞脂肪变的发生主要与患者的代谢因素相关，而非HBV所致。Objective To explore the viral and host causes of hepatosteatosis in chinese patient with chronic hepatitis B. Methods A total of 562 patients （450 males and 112 females, age range 13-80 years） with biospy-proven chronic hepatitis B were enrolled in the study. The patients were divided into two groups： group without steatosis （460 patients） and group with steatosis （102 patients）. The groups were compared in terms of age, gender, body mass index （BMI）, liver enzymes, cholesterol, triglyceride, APO-A, APO-B, urine acid （UA）, fasting serum glucose（FSG） and HBeAg, viral load. Results Steatosis was present in 102 patients （18.15%）. The degree of liver steatosis in 97 （95.10%） patients were less 30%. Steatosis was found in 98 （21.78%） of male patients and 4 （3.75%） of female patients （ P 〈 0.01）. In the group of chronic hepatitis B with steatosis, the prevalence of obesity, diabetes mellitus, dyslipidaemia, alcoholic consumption, the BMI, cholesterol, triglyceride, UA and FSG levels were significantly higher than those in the group without steatosis （ P 〈 0.01 ）. No significant difference was found in the mean age, HBeAg, viral load between the two groups （P 〉 0.05）. Logistic regression analysis demonstrated that the present of steatosis was positively correlated to BMI, TG and UA. Conclusion Hepatosteatosis in chronic hepatitis B appears to be a result of metabolic factors of the host rather than the effect of viruses.

关 键 词：肝炎病毒 乙型 肝炎 乙型 慢性 肝细胞 脂肪肝 

分 类 号：R512.62[医药卫生—内科学] R512.6[医药卫生—临床医学]