核苷类似物治疗慢性乙型肝炎至病毒学应答后谷丙转氨酶异常的因素分析  

Analysis on factors of abnormal alanine aminotransferase after virological response of patients with chronic hepatitis B treated with nucleoside analogues

作　　者：祝达 郭玉杰 陈丽文 张倩华 高文军 ZHU Da;GUO Yujie;CHEN Liwen;ZHANG Qianhua;GAO Wenjun(Department of Hepatology,Zhongshan Second People’s Hospital,Guangdong,Zhongshan 528400,China)

机构地区：[1]广东省中山市第二人民医院肝病科,广东中山528400

出　　处：《中国医药科学》2022年第3期20-23,50,共5页China Medicine And Pharmacy

基　　金：广东省中山市医学科研项目(2018J154)。

摘　　要：目的研究初次经核苷类似物治疗慢性乙型肝炎(CHB)至病毒学应答后谷丙转氨酶(ALT)异常患者的临床特点,并分析ALT异常的危险因素。方法回顾性收集并筛选出2017年1月至2020年3月中山市第二人民医院收治的72名初次经核苷类似物治疗的CHB患者,根据病毒应答后ALT结果分为ALT异常组(n=18)及ALT正常组(n=54)。记录并比较两组患者的一般资料及病毒学应答时的肝功能。进行logistic回归分析,了解病毒应答后ALT异常的危险因素。结果ALT异常组血白蛋白、白细胞水平以及合并脂肪肝的比率均高于ALT正常组,差异有统计学意义(P<0.05)。合并脂肪肝是CHB病毒学应答后ALT异常的危险因素(OR=14.013,P<0.05)。结论CHB患者经核苷类似物治疗至病毒学应答后,ALT异常的原因可能是合并脂肪肝。Objective T o s t u d y t h e c l i n i c a l c h a r a c t e r i s t i c s o f p a t i e n t s w i t h a b n o rma l a l a n i n e aminotransferase(ALT)after the first treatment of chronic hepatitis B(CHB)with nucleoside analogues to hepatitis B virus(HBV)response,and analyze the risk factors of abnormal ALT.Methods A total of 72 patients with CHB who were treated with nucleoside analogues for the first time in Zhongshan Second People’s Hospital from January 2017 to March 2020 were collected and screened retrospectively.They were divided into the abnormal ALT group(n=18)and the normal ALT group(n=54)according to the results of ALT after HBV response.The baseline clinical data and liver function during virological response were recorded and compared between the two groups.Logistic regression analysis was conducted to understand the risk factors of abnormal ALT after HBV response.Results The level of serum albumin and white blood cells and complicated fatty liver were higher in the abnormal ALT group than that in the normal ALT group,with statistically significant differences(P<0.05).The complicated fatty liver was a risk factor for abnormal ALT after HBV response(OR=14.013,P<0.05).Conclusion After patients with CHB receive nucleoside analogues to HBV response,the abnormal ALT may be caused by fa tty liver.

关 键 词：代谢相关脂肪性肝病 慢性乙型肝炎 病毒学应答 生化学异常 

分 类 号：R512.62[医药卫生—内科学]