[肝脂肪变性对聚乙二醇化干扰素-α-2a治疗慢性乙型肝炎患者疗效的影响]
[Impact of liver steatosis on the curative effect of pegylated interferon-alpha-2a in patients with chronic hepatitis B].
作者信息
Xu Liang, Li Ping, Shi Qiyu, Mi Yuqiang
机构信息
Department two of Combination of Chinese Traditional and Western Medicine, the Second People Hospital of Tianjin, Tianjin Medical Research Institute of LiverDisease, Tianjin 300192, China.
出版信息
Zhonghua Gan Zang Bing Za Zhi. 2015 Feb;23(2):99-102. doi: 10.3760/cma.j.issn.1007-3418.2015.02.005.
OBJECTIVE
To investigate the impact of hepatic steatosis on virologic response to treatment with pegylated interferon-alpha-2a (PEG-IFNα-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-IFNα-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 blood glucose 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 ( less than 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 (x2=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-IFNα-2a treatment for patients with CHB.
目的
探讨肝脂肪变性对慢性乙型肝炎（CHB）患者接受聚乙二醇化干扰素-α-2a（PEG-IFNα-2a）治疗的病毒学应答的影响。
方法
我们回顾性分析了2005年至2009年期间在我院接受48周PEG-IFNα-2a治疗的50例经活检证实的CHB患者。根据病理检查结果确认的脂肪变性情况对患者进行分层，非脂肪变性组28例，脂肪变性组22例（轻度脂肪变性21例，中度脂肪变性1例）。
结果
收集血常规、肝肾功能、空腹血糖、甲状腺功能和血脂检查结果进行分析，同时收集乙型肝炎病毒载量检测、乙型肝炎病毒（HBV）标志物及自身抗体检测结果。通过对治疗48周前后的结果进行统计学比较，比较分层组之间的抗病毒治疗疗效和副作用。
结果
治疗结束时，非脂肪变性组42.9%的患者HBV-DNA检测不到（低于500拷贝/ml），乙型肝炎e抗原（HBeAg）血清学转换率为31.6%，完全缓解率为39.3%。脂肪变性组HBV-DNA检测不到的患者比例较低（40.9%），HBeAg血清学转换率（33.3%）和完全缓解率（40.9%）较高，但差异均未达到统计学意义阈值（χ2分别为0.012、0.019、0.014，P分别为0.560、0.600、0.568）。两组治疗后甘油三酯水平均显著升高（脂肪变性组：t=-2.164，P=0.040；非脂肪变性组：t=-2.863，P=0.009），且两组间差异有统计学意义（t=2.41，P=0.020）。
结论
我们的研究未显示轻度肝脂肪变性会影响CHB患者接受48周PEG-IFNα-2a治疗的疗效。
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