脂肪肝对聚乙二醇干扰素α联合阿德福韦酯治疗慢性乙型肝炎疗效影响的观察  

Impact of liver steatosis on response to pegylated interferon combined with adefovir therapy in patients with chronic hepatitis B

作　　者：张晓宇[1] 黄海英[1] 李树臣[1] 李明荣[1] 

机构地区：[1]哈尔滨医科大学附属第二医院感染病科,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2013年第4期347-349,共3页Journal of Harbin Medical University

摘　　要：目的探讨脂肪肝对聚乙二醇干扰素(Peg-IFNα)联合阿德福韦酯治疗慢性乙型肝炎(chronic hepatitis B,CHB)疗效的影响。方法对2008～2011年就诊于本院82例HBeAg阳性CHB患者,经肝脏彩超检查证实合并脂肪肝者28例(脂肪肝组)、无脂肪肝者54例(无脂肪肝组),均应用聚乙二醇干扰素(Peg-IFNα)联合阿德福韦酯治疗48周。比较两组患者基线情况及治疗结束时病毒学和生化学应答情况的差异。结果脂肪肝组的平均体重指数(28.6±5.7)kg/m2明显高于无脂肪肝组(25.4±6.1)kg/m2(P<0.05)。治疗结束时,无脂肪肝组与脂肪肝组比较,e抗原血清学转换率(44.4%与32.1%)和病毒学应答率(68.5%与57.1%)、生化学应答率(70.4%与60.7%)在无脂肪肝组均高于脂肪肝组,但差异无统计学意义。在53例获得病毒学应答患者中,22例无生化学应答,其中脂肪肝组10例(62.5%),无脂肪肝组12例(32.4%),差异有统计学意义(P<0.05)。结论脂肪肝在慢性乙型肝炎患者中的发生率明显升高。脂肪肝对慢性乙型肝炎患者应用乙二醇干扰素α联合阿德福韦酯治疗的效果无显著影响,但可能影响患者生化学应答。Objective To investigate the impact of hepatic steatosis on the outcome ed interferon-alpha （PEG- IFNα） plus adefovir therapy in chronic hepatitis B （ tients. Methods The medical records of 82 patients who were diagnosed with CHB of pegylat- CHB ） papositive for hepatitis B e antigen（HBeAg） and received pegylated interferon-alpha（PEG-IFNα） plus ade- fovir for 48 weeks between 2008 and 2011 were analyzed retrospectively. Body mass index （BMI） values at baseline and virologic response and biochemical response were compared be- tween patients with （n = 28） and without （n = 54 ） steatosis who were proven by ultrosound. Results The BMI in the steatosis group was significant higher than that of non-steatosis group, which were （28. 6 ±5.7） vs. （25.4± 6. 1 ） kg/m2, P 〈 0. 05. After 48 weeks treatment of PEG-IFNa plus adefovir, there was no significant difference in HBeAg seroconversion or the percentage of undetectable HBV DNA （ 〈 21og10 copies/mL） and biochemical response between steatosis and non-steatosis patients. Of the 53 CHB patients with undetectable HBV DNA after 48 weeks ot treatment , 22 patients did not achieve ALT normalization.The rate of non-bio-chemical response was significantly higher in the steatosis group than that in the non-steatosis group （62. 5% vs. 32.4%, P 〈 0. 05）. Conclusion Occurrence of hepatic steatosis is sig- nificantly high in CHB patients. Hepatic steatosis has no significant impact on the outcome of pegylated interferon-alpha（PEG-IFNa） plus adefovir treatment. However it may influence the biochemical response.

关 键 词：干扰素Α 阿德福韦酯 脂肪肝 慢性乙型肝炎 

分 类 号：R512.62[医药卫生—内科学]