PR治疗慢性丙型肝炎患者营养风险的影响因素分析  

The influence factor analysis of nutritional risk in treatment of pegylated interferon and ribavirin in patients with chronic hepatitis C

作　　者：张弘[1,2,3] 李菲[2,3] 衡明莉[1] 卢诚震[2,3] 孙云红[2,3] 王泓午[1] 曹武奎[2,3] ZHANG Hong;LI Fei;HENG Mingli;LU Chengzhen;SUN Yunhong;WANG Hongwu;CAO Wukui(Department of Epidemiology,Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China;Tianjin Secondary People’s Hospital;Tianjin Liver Disease Research Institute)

机构地区：[1]天津中医药大学公共卫生教研室,300193 [2]天津市第二人民医院 [3]天津肝病研究所

出　　处：《天津医药》2016年第12期1472-1475,共4页Tianjin Medical Journal

基　　金：国家科技重大专项课题(2012ZX10005004-003)

摘　　要：目的探讨使用聚乙二醇干扰素联合利巴韦林(PR)治疗的慢性丙型肝炎(丙肝)患者出现营养风险的影响因素。方法选取接受PR治疗的慢性丙肝患者175例,测量身高、体质量,计算体质指数(BMI),用营养风险筛查2002(NRS 2002)来进行营养风险评估,并分为有风险组(140例)和无风险组(35例)。结果 2组间年龄、HCV基因型、临床类型、治疗时间及干扰素或利巴韦林是否减量差异有统计学意义(P<0.05)。Logistic回归分析显示:高龄(OR值16.068,β值2.777)、干扰素减量(OR值3.096,β值1.130)、利巴韦林减量(OR值3.382,β值1.219)以及进展至肝硬化的慢性丙肝(OR值5.092,β值1.628)为营养风险的危险因素;而HCV基因型为非1b型者(OR值0.384,β值-0.957)为营养风险的保护因素。结论接受PR治疗的慢性丙肝患者营养风险发生率高。高龄、对PR不耐受、慢性丙肝进展为肝硬化的患者为发生营养风险的独立危险因素,而非1b型HCV感染者不易发生营养风险。Objective To explore the nutritional risk factors in patients with chronic hepatitis C (CHC), who have been accepted pegylated interferon (IFN) and ribavirin (RVB) therapy (PR). Methods A total of 175 CHC patients treated with PR were included in this study. Data of heights, body weights, and calculated body mass index (BMI) were recorded in patients. At the same time, patients were evaluated nutritional risk with Nutritional Risk Screen 2002 (NRS 2002), and divided into risk group (n=35) and non-risk group (n=140). Results There were significant differences in age, HCVgenotype (1b type and not 1b), clinical type (CHC/cirrhosis), the length of treatment time and the tolerance degree for PRtherapy between two groups (P<0.05). Logistic regression analysis showed that age (OR=16.068, β=2.777), IFN dosage(OR=3.096, β =1.130), RVB dosage (OR=3.382, β =1.219) and clinical type (OR=5.092, β =1.628) were nutritional risk factors. The HCV genotype (OR=0.384; β =-0.957) was protective factors for nutritional risk. Conclusion There is higher occurrence rate of nutritional risk for CHC patients accepted PR therapy. The dependant nutritional risk factors are advanced age, intolerance for PR therapy and cirrhosis associated CHC. HCV without genotypes 1b is not a nutritional risk factor.

关 键 词：肝炎 丙型 慢性 干扰素Α-2A 聚乙烯二醇类 利巴韦林 LOGISTIC模型 营养风险 

分 类 号：R512.63[医药卫生—内科学]