CAJ | 학술논문

目的探讨肝脂肪变对慢性乙型肝炎(CHB)患者应用聚乙二醇干扰素α-2a(PEG-IFNα-2a)抗病毒疗效的影响.方法对2005年至2009年经肝组织病理学检查确诊的应用PEG-IFNα-2a抗病毒治疗且资料齐全的50例CHB患者进行回顾性分析,依据病理学检测结果将其分为无脂变组(28例)、脂变组(轻度脂肪变21例、中度脂肪变1例).检测血常规、肝肾功能、空腹血糖、血脂,荧光定量PCR法检测HBV DNA载量(下限为500拷贝/rnl),采用电化学发光法检测HBV标志物(HBsAg、抗-HBs、HBeAg、抗-HBe)及甲状腺功能;分析比较两组患者治疗48周时的抗病毒疗效、不良反应情况.对数据中的计量资料采用t检验、计数资料采用x2检验进行统计学分析. 结果无脂变组HBV DNA阴转率(＜500拷贝/ml)为42.9％,HBeAg/抗-HBe血清学转换率为31.6％,完全应答率39.3％;脂变组HBV DNA阴转率为40.9％,HBeAg/抗-HBe血清学转换率为33.3％,完全应答率40.9％,经x2检验(x2值分别为0.012,0.019,0.014,P值分别为0.600,0.560,0.568),未发现两组患者抗病毒治疗48周时的疗效差异存在统计学意义.两组患者抗病毒治疗后甘油三酯均较治疗前升高(无脂变组t=-2.164,P＜0.05;脂变组t=-2.863,P＜0.05);治疗后两组甘油三酯差异有统计学意义(t=2.412,P＜0.05). 结论本研究未发现轻度肝脂肪变对CHB患者应用PEG-IFNα-2a抗病毒治疗48周时的疗效有明显影响.
목적 탐토간지방변대만성을형간염(CHB)환자응용취을이순간우소α-2a(PEG-IFNα-2a)항병독료효적영향.방법 대2005년지2009년경간조직병이학검사학진적응용PEG-IFNα-2a항병독치료차자료제전적50례CHB환자진행회고성분석,의거병이학검측결과장기분위무지변조(28례)、지변조(경도지방변21례、중도지방변1례).검측혈상규、간신공능、공복혈당、혈지,형광정량PCR법검측HBV DNA재량(하한위500고패/rnl),채용전화학발광법검측HBV표지물(HBsAg、항-HBs、HBeAg、항-HBe)급갑상선공능;분석비교량조환자치료48주시적항병독료효、불량반응정황.대수거중적계량자료채용t검험、계수자료채용x2검험진행통계학분석. 결과 무지변조HBV DNA음전솔(＜500고패/ml)위42.9％,HBeAg/항-HBe혈청학전환솔위31.6％,완전응답솔39.3％;지변조HBV DNA음전솔위40.9％,HBeAg/항-HBe혈청학전환솔위33.3％,완전응답솔40.9％,경x2검험(x2치분별위0.012,0.019,0.014,P치분별위0.600,0.560,0.568),미발현량조환자항병독치료48주시적료효차이존재통계학의의.량조환자항병독치료후감유삼지균교치료전승고(무지변조t=-2.164,P＜0.05;지변조t=-2.863,P＜0.05);치료후량조감유삼지차이유통계학의의(t=2.412,P＜0.05). 결론 본연구미발현경도간지방변대CHB환자응용PEG-IFNα-2a항병독치료48주시적료효유명현영향.
Objective To investigate the impact of hepatic steatosis on virologic response to treatment with pegylated interferon-alpha-2a (PEG-IFNct-2a) in chronic hepatitis B (CHB) patients.Methods We retrospectively analyzed 50 biopsy-proven cases of CHB in patients who had been administered a 48-week course of PEG-IFNa-2a in our hospital between 2005 and 2009.The patients were stratified according to presence of steatosis confirmed by pathological findings,with 28 in the non-steatosis group and 22 in the steatosis group (21 with mild steatosis,and 1 with moderate steatosis).Results from blood routine test,hepatic and renal function tests,fasting bloodglucose test,thyroid function test and blood lipid test were collected for analysis,as were results from hepatitis B viral load test and detection of hepatitis B virus (HBV) markers and autoantibodies.The efficacy of antiviral treatment and side effects were compared between the stratified groups by statistically comparing the results from before and after the 48 weeks of treatment.Results At the end of treatment,the non-steatosis group had 42.9％ of patients with undetectable HBV-DNA (＜ 500 copies/ml),a hepatitis B e antigen (HBeAg) seroconversion rate of 31.6％ and a complete response rate of 39.3％.The steatosis group had a lower rate of patients with undetectable HBV-DNA (40.9％) and higher rates of HBeAg seroconversion (33.3％) and complete response (40.9％),but none of the differences reached the threshold for statistical significance (x 2 =0.012,0.019,0.014 and P =0.560,0.600,0.568 respectively).Both groups showed significant increases in triglyceride levels after treatment (steatosis group:t =-2.164,P =0.040; non-steatosis group:t =-2.863,P =0.009),and there was a significant difference between the two groups (t =2.41,P =0.020).Conclusion Our study did not show that mild hepatic steatosis affected the efficiency of a 48-week course of PEG-IFNct-2a treatment for patients with CHB.