阿德福韦酯对乙肝合并脂肪肝疗效分析  

Efficacy of adefovir therapy on liver steatosis in hepatitis B patients

作　　者：王艳玲[1] 张冰[1] 李炳庆[1] 时军利[1] 王磊[1] 

机构地区：[1]河北省承德市承德医学院附属医院消化内科,河北承德067000

出　　处：《热带医学杂志》2016年第10期1272-1274,共3页Journal of Tropical Medicine

基　　金：河北省承德市科学技术研究与发展计划项目(20142034);河北省重点专科项目(冀卫医函[2013]9号)

摘　　要：目的探讨阿德福韦酯对HBe Ag阳性慢性乙型肝炎合并脂肪肝患者抗病毒疗效的作用。方法选择2011-2014年在承德医学院附属医院就诊的e抗原阳性慢性乙型肝炎(CHB)患者204例,按照有无合并脂肪肝分为两组,单纯乙肝组122例为对照组,乙肝合并非酒精性脂肪肝(NAFID)82例为观察组。两组患者均给予阿德福韦酯10mg/d口服治疗24、36、48周,观察两组丙氨酸氨基转移酶/天门冬氨酸基转移酶(ALT/AST)复常率(生物化学应答)、HBe Ag阴转率(血清学应答)及HBV-DNA阴转率(病毒学应答)。结果单纯CHB组ALT/AST复常率、HBVDNA阴转率及HBe Ag阴转率在治疗24和36周时显著高于乙肝合并脂肪肝组,两组相比差异有统计学意义(P<0.05);在治疗48周时单纯CHB组和合并脂肪肝组ALT/AST复常率差异有统计学意义(P<0.05),但HBV-DNA阴转率和HBe Ag阴转率差异无统计学意义(P>0.05)。结论脂肪肝对HBe Ag阳性慢性乙型肝炎患者应用阿德福韦酯抗病毒治疗有一定影响,延长阿德福韦酯治疗疗程可减少这种影响。Objective To investigate the antiviral effect of adefovir therapy on HBeAg positive chronic hepatitis B （CHB） patients with nonalcoholic fatty liver disease. Methods 204 patients diagnosed with CHB positive for hepatitis B e antigen （HBeAg） were selected from 2011 to 2014 in the Chengde medical college affiliated hospital for the study , and were treated with adefovir for 48 weeks. Baseline status and virological response, biochemical response and serology response were compared between patient with （n=82） and without （n=122） steatosis, who were proven by ultrasound. Results After 24 weeks treatment and 36 weeks treatment of adefovir therapy, there was significant differences in HBeAg seroconversion, the percentage of undetectable HBV-DNA and biochemical response between steatosis and non-steatosis patients. But , after 48 weeks treatment of adefovir therapy, there were no significant differences in HBeAg seroconversion, the percentage of undetectable HBV-DNA between the two group of patients; and there was significant difference in biochemical response between the two group. Conclusion Hepatic steatosis has significant impact on the outcome of adefovir treatment, and if the time of adefovir treatment could be prolonged, this influence could be disappeared.

关 键 词：阿德福韦酯 非酒精性脂肪肝 乙型肝炎 

分 类 号：R512.62[医药卫生—内科学]