CAJ | 학술논문

目的探讨肝脂肪变对聚乙二醇干扰素α (Peg-IFNα)治疗慢性乙型肝炎(CHB)患者临床疗效的影响.方法　96例HBeAg阳性CHB初治患者,经肝活组织检查证实合并肝脂肪变者34例(肝脂肪变组)、无肝脂肪变者62例(无肝脂肪变组),均用Peg-IFN α[治疗,疗程为48周,比较两组患者治疗结束时病毒学应答和生化学应答的差异.每组均数差异的比较采用t检验,率的比较采用x2检验.结果　HBV DNA滴度肝脂肪变组患者为(6.96±1.27) lg10拷贝/ml,无肝脂肪变组患者为(7.54±1.28) lg10拷贝/ml,两组比较,t=2.161,P=0.033,差异有统计学意义.Peg-1FN α[治疗48周时,HBeAg转换率、HBV DNA阴转率在肝脂肪变组分别为35.2％ (12/34)和44.1％ (15/34);无肝脂肪变组分别为38.7％ (24/62)和48.3％ (30/62),两组比较,差异无统计学意义.完全应答率在肝脂肪变组为26.5％,无肝脂肪变组为48.4％,两组比较,x2=4.373,P=0.037,差异有统计学意义.在45例HBV DNA转阴患者中,7例无生化学应答,其中肝脂肪变组有5例,无肝脂肪变组2例,无生化应答率肝脂肪变组显著高于无肝脂肪变组,P=0.032,差异有统计学意义. 结论 CHB患者合并肝脂肪变不影响Peg-1FN α[治疗48周时病毒学应答,但可能会影响其生化学应答.
목적 탐토간지방변대취을이순간우소α (Peg-IFNα)치료만성을형간염(CHB)환자림상료효적영향.방법　96례HBeAg양성CHB초치환자,경간활조직검사증실합병간지방변자34례(간지방변조)、무간지방변자62례(무간지방변조),균용Peg-IFN α[치료,료정위48주,비교량조환자치료결속시병독학응답화생화학응답적차이.매조균수차이적비교채용t검험,솔적비교채용x2검험.결과　HBV DNA적도간지방변조환자위(6.96±1.27) lg10고패/ml,무간지방변조환자위(7.54±1.28) lg10고패/ml,량조비교,t=2.161,P=0.033,차이유통계학의의.Peg-1FN α[치료48주시,HBeAg전환솔、HBV DNA음전솔재간지방변조분별위35.2％ (12/34)화44.1％ (15/34);무간지방변조분별위38.7％ (24/62)화48.3％ (30/62),량조비교,차이무통계학의의.완전응답솔재간지방변조위26.5％,무간지방변조위48.4％,량조비교,x2=4.373,P=0.037,차이유통계학의의.재45례HBV DNA전음환자중,7례무생화학응답,기중간지방변조유5례,무간지방변조2례,무생화응답솔간지방변조현저고우무간지방변조,P=0.032,차이유통계학의의. 결론 CHB환자합병간지방변불영향Peg-1FN α[치료48주시병독학응답,단가능회영향기생화학응답.
Objective To investigate the impact of hepatic steatosis on virologic response in chronic hepatitis B (CHB) patients treated with pegylated interferon-alpha (PEG-IFNa).Methods Ninety-six naive patients postive for hepatitis B e antigen (HBeAg) and with biopsy-proven CHB were administered PEG-IFNa-2a or PEG-IFNa-2b for 48 weeks.Virologic response (HBeAg clearance and hepatitis B virus (HBV) DNA ＜ 5 log10 copies/ml) and biochemical response (alanine transaminase (ALT) normalization) were compared between patients with (n =34) and without (n=62) steatosis.Results The HBV DNA titer in the steatosis group was significantly lower than that of the non-steatosis group (6.961.27 vs.7.541.28 log10 copies/rnl; t=2.161,P=0.033).Atter 48weeks ofPEG-IFNa treatements,there was no significant difference in HBeAg seroconversion or the percentage of undetectable HBV DNA (＜ 3 log10 copies/ml) between steatosis and non-steatosis patients.However,the steatosis patients presented with a significantly lower complete response rate (virologic response plus biochemical response)compared to non-steatosis patients (26.5％ vs.48.4％; x2 =4.373,P =0.037).Of the 45 CHB patients with undetectable HBV DNA after 48 weeks of treatment,seven did not achieve ALT normalization.The rate of patients with non-biochemical response was significantly higher in the steatosis group than in the non-steatosis group (33.3％vs.6.67％; P =0.032).Conclusions Hepatic steatosis does not affect the virologic response,but does affect the biochemical response in CHB patients treated with PEG-IFNa for 48 weeks.