肝细胞脂肪变对干扰素抗乙型肝炎病毒治疗应答的影响及相关因素研究  

Effect of Hepatic Steatosis on the Response to the α-2b PEG interferon-based Anti-HBV therapy and Related Factors Research

作　　者：武瑞[1] 娄国强[2] 施军平[2] 刘寿荣[1] 王江娅[1] 

机构地区：[1]杭州市西溪医院( 杭州市第六人民医院) 肝病科,310000 [2]杭州市第二人民医院肝病科

出　　处：《医学研究杂志》2014年第11期103-106,共4页Journal of Medical Research

摘　　要：目的 明确肝细胞脂肪变对干扰素抗乙型肝炎病毒（HBV）治疗应答的影响.方法 2007年9月～ 2008年10月期间,对经肝活检证实的合并肝细胞脂肪变的21例慢性乙型肝炎（CHB）患者和无肝细胞脂肪变的55例CHB患者分别应用α-2b PEG干扰素进行抗HBV治疗,观察两组治疗应答情况（丙氨酸氨基转移酶复常率、乙型肝炎e抗原血清阴转率和血清转换率、乙型肝炎病毒载量阴转率）,研究肝细胞脂肪变对干扰素抗HBV治疗应答的影响.结果 在2007年9月～2008年10月进行干扰素治疗的76名CHB患者中,男性57名,女性19名,平均年龄29.00±8.32岁.随访第12、24和48周时脂肪变组的ALT复常率与无脂肪变组比较分别为36.8％（7/19） vs 29.7％（11/37）、23.5％ （4/17） vs 44.4％ （12/27）、43.8％ （7/16） vs61.1％（11/18）,两组分别比较差异均无统计学意义（P＞0.05）.随访48周结束时,脂肪变组中有1例出现HBsAg阴转6.3％ （1/16）,无脂肪变组中有2例出现HBsAg阴转11.1％ （2/18）,并且有1例出现HBsAg血清学转换5.6％ （1/18）.随访第12、24和48周时脂肪变组与无脂肪变组HBeAg阴转率与血清学转换率分别相同,为33.3％ （6/18） vs21.2％（7/33）、37.5％ （6/16）vs 27.6％（8/29）、56.3％ （9/16）vs27.8％ （5/18）,两组分别比较差异均无统计学意义（P＞0.05）.随访第12、24和48周时脂肪变组与无脂肪变组HBV-DNA的阴转率分别为38.9％ （7/18）vs 36.7％ （11/30）、50％ （8/16）vs 32.1％ （9/28）、75％ （12/16）vs 61％（11/18）,两组分别比较差异均无统计学意义（P＞0.05）.结论 肝细胞脂肪变也是CHB患者常见的病理表现之一,它对α-2bPEG干扰素抗HBV治疗应答无明显影响.Objective To evaluate the response to the interferon-based anti-HBV therapy.Methods Twenty-one CHB patients with steatosis and fifty-five CHB patients without steatosis underwent liver biopsy from September 2007 to October 2008.All of them received the α-2b PEG interferon-based anti-HBV therapy.The information of responses rate of treatment between the two groups including ALT normalization rate,HBeAg loss rate,HBeAg seroconversion rate and HBV-DNA loss rate were reviewed.The effect of hepatic steatosis on the response to the α-2b interferon-based anti-HBV therapy were studied.Results Seventy and six patients with CHB received the α-2b PEG interferon-based anti-HBV therapy from September 2007 to October 2008.The mean age of the patients was 29.00 ± 8.32 years;57 men and 19 women.In CHB patients with steatosis group,ALT normalization rates were 36.8％,23.5％ and 44.4％ after 12,24 and 48 weeks of followo-up,respectively.Compared with those in CHB patients without steatosis group,there was no significant statistical differences （P ＞0.05）.There is identical that the HBeAg loss rate and HBeAg seroconversion rate which were 33.3 ％ vs 21.2％,37.5％ vs 27.6％,56.3％ vs 27.8％ after 12,24 and 48 weeks of followo-up,respectively in the two groups.There was also no significant statistical differences （P ＞ 0.05） in the two groups.One patients of HBsAg loss emerge in CHB patients with steatosis group and one patients of HBsAg seroconversion presence in CHB patients without steatosis group after 48 weeks of followo-up.In CHB patients with steatosis group,HBV-DNA loss rates were 38.9％,50％ and 75％ after 12,24 and 48 weeks of followo-up,respectively.Compared with those in CHB patients without steatosis group,there was no significant statistical differences （P ＞ 0.05） also.Conclusion Hepatic steatosis is one of the common patho-conditions in patients with CHB,but it appears nomanifest effect on the response to the α -2b PEG interferon-based anti-HBV therapy.

关 键 词：肝炎 乙型 慢性 肝脂肪变 干扰素 

分 类 号：R4[医药卫生—临床医学]