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聚乙二醇干扰素与利巴韦林联合治疗丙型肝炎病毒显著影响脂代谢。

Treatment of hepatitis C virus with peg-interferon and ribavirin combination therapy significantly affects lipid metabolism.

机构信息

Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.

出版信息

Hepatol Res. 2009 Feb;39(2):195-9. doi: 10.1111/j.1872-034X.2008.00439.x. Epub 2008 Nov 5.

Abstract

AIM

We investigated lipid metabolism in patients with chronic hepatitis C virus (HCV), serotype 1, undergoing combination therapy with PEG-IFN alpha-2b (PEG-IFN) and ribavirin (RBV).

METHODS

A total of 185 patients with chronic HCV (HCV serotype 1; HCV RNA levels >/= 100 KIU/mL) who received a combination of PEG-IFN and RBV were enrolled.

RESULTS

Sustained virological response (SVR) was obtained in 82 cases (44.3%). The median age, red blood cell and platelet counts differed significantly between the SVR and non-SVR groups before treatment. However there was no significant difference between total cholesterol (TC), LDL-cholesterol (LDL-C) and triglyceride (TG) levels before treatment. TC and LDL-C levels decreased during the treatment in both groups. In the SVR group, TC and LDL-C levels increased quickly after the end of the treatment and were higher than those before treatment. On the other hand, TC and LDL-C levels returned to pretreatment levels in the non-SVR group and were significantly lower than in the SVR group. TG levels were elevated in both groups after the beginning of treatment. After the end of treatment, this elevation persisted in the SVR group, while TG levels returned to pre-treatment levels in the non-SVR group. There was a significant difference in TG levels at 24 weeks after the end of the treatment between the 2 groups. In the non-SVR group some patients achieved normalization of ALT (alanine aminotransferase) but persistence of normal ALT levels did not contribute to the increase of TC and TG.

CONCLUSION

TC, LDL-C and TG levels increase only in patients with HCV, serotype 1, undergoing combination therapy when a SVR is achieved.

摘要

目的

我们研究了慢性丙型肝炎病毒(HCV),1 型患者在聚乙二醇干扰素 α-2b(PEG-IFN)和利巴韦林(RBV)联合治疗中的脂代谢变化。

方法

共纳入 185 例慢性丙型肝炎(HCV 1 型;HCV RNA 水平>/=100 KIU/mL)患者,接受 PEG-IFN 和 RBV 联合治疗。

结果

82 例(44.3%)获得持续病毒学应答(SVR)。治疗前,SVR 组和非 SVR 组的中位年龄、红细胞和血小板计数差异有统计学意义。然而,治疗前两组的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和甘油三酯(TG)水平无显著差异。两组治疗过程中 TC 和 LDL-C 水平均降低。在 SVR 组,治疗结束后 TC 和 LDL-C 水平迅速升高,高于治疗前。另一方面,非 SVR 组 TC 和 LDL-C 水平恢复到治疗前水平,明显低于 SVR 组。两组治疗后 TG 水平升高。治疗结束后,SVR 组 TG 水平持续升高,而非 SVR 组 TG 水平恢复到治疗前水平。治疗结束后 24 周两组间 TG 水平差异有统计学意义。在非 SVR 组,一些患者的 ALT(丙氨酸氨基转移酶)恢复正常,但正常 ALT 水平的持续存在并不能导致 TC 和 TG 水平的升高。

结论

仅在慢性丙型肝炎 1 型患者实现 SVR 时,联合治疗才会导致 TC、LDL-C 和 TG 水平升高。

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