CAJ | 학술논문

目的：探讨脂肪肝对HBeAg阳性慢性乙型肝炎患者应用阿德福韦酯抗病毒疗效的影响。方法：选择2011年1月至2013年12月在我院门诊就诊的HBeAg 阳性慢性乙型肝炎患者154例为研究对象，其中单纯乙肝者86例为对照组，乙肝合并非酒精性脂肪肝（NAFLD）者68例为观察组。2组患者均给予阿德福韦酯10 mg／d口服抗病毒治疗24周后，观察2组ALT／AST复常率（生物化学应答）、HBeAg阴转率（血清学应答）及HBV DNA阴转率（病毒学应答）有无差异。结果：观察组ALT／AST复常率为67．6％，显著低于对照组（83．7％），差异具有统计学意义（P ＜0．05）；对照组 HBV DNA 阴转率（81．4％）及 HBeAg 阴转率（69．8％）均显著高于观察组（HBV DNA阴转率58．8％，HBeAg 阴转率44．1％），且2组差异均具有统计学意义（P ＜0．05）。结论：脂肪肝对HBeAg阳性慢性乙型肝炎患者应用阿德福韦酯抗病毒的疗效有一定影响。
목적：탐토지방간대HBeAg양성만성을형간염환자응용아덕복위지항병독료효적영향。방법：선택2011년1월지2013년12월재아원문진취진적HBeAg 양성만성을형간염환자154례위연구대상，기중단순을간자86례위대조조，을간합병비주정성지방간（NAFLD）자68례위관찰조。2조환자균급여아덕복위지10 mg／d구복항병독치료24주후，관찰2조ALT／AST복상솔（생물화학응답）、HBeAg음전솔（혈청학응답）급HBV DNA음전솔（병독학응답）유무차이。결과：관찰조ALT／AST복상솔위67．6％，현저저우대조조（83．7％），차이구유통계학의의（P ＜0．05）；대조조 HBV DNA 음전솔（81．4％）급 HBeAg 음전솔（69．8％）균현저고우관찰조（HBV DNA음전솔58．8％，HBeAg 음전솔44．1％），차2조차이균구유통계학의의（P ＜0．05）。결론：지방간대HBeAg양성만성을형간염환자응용아덕복위지항병독적료효유일정영향。
Objective To investigate the impact of hepatic steatosis on the outcome of adefovir therapy in chronic hepatitis B patients with HBeAg positive. Methods The medical records of 154 patients who were diagnosed with CHB positive for hepatitis B e antigen (HBeAg) and received adefovir therapy for 24 weeks between January, 2011 and December, 2013 were analyzed retrospectively. Baseline status and virologic response, biochemical response and serology response between patient with (n = 68) and without (n = 86) steatosis who were proven by ultrasound. Both groups were given oral adefovir dipivoxil 10 mg/d for 24 weeks , recovery rate in ALT/AST, negative conversion rate of HBV DNA and HBeAg were recorded and compared. Results Recovery rate in ALT/AST in observation group was 67.7%, which is lower than control group (83.7%), and the difference is significant(P < 0.05). Negative conversion rate of HBV DNA and HBeAg in control group is 81.4%and 83.7%, which is significantly higher than observation group (whose values are 58.8% and 44.1%, P < 0.05). Conclusion Hepatic steatosis has significant impact on the outcome of adefovir treatment.