阿德福韦酯对慢性乙型肝炎合并脂肪肝患者抗病毒疗效的影响分析
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摘要
目的研究阿德福韦酯对慢性乙型肝炎合并脂肪肝患者抗病毒疗效的影响。方法选取我院2016年1～12月收治的140例慢性乙型肝炎患者作为研究对象,按随机排列表法分成单纯组和合并组,各70例,单纯组为单纯慢性乙型肝炎患者,合并组为慢性乙型肝炎合并脂肪肝患者,两组均给予阿德福韦酯抗病毒治疗,治疗24周后将两组的生物化学应答、病毒学应答和血清学应答情况进行对比。结果单纯组氨基转移酶复常率72.86%、HBVDNA阴转率67.14%以及HBeAg阴转率57.14%,分别优于合并组的55.71%、51.43%、38.57%,且两组获得病毒学应答患者中,单纯组氨基转移酶复常率(93.62%)优于合并组(66.67%),差异具有统计学意义(P<0.05);两组获得病毒学应答患者中,单纯组、合并组的HBeAg阴转率分别为78.72%、72.22%,差异无统计学意义(P>0.05)。结论肝脂肪样病变对慢性乙型肝炎患者接受抗病毒治疗的效果会产生一定影响,因此在对乙肝合并脂肪肝患者进行抗病毒治疗时,还要注意对脂肪肝进行治疗。
Objective To study the effect of adefovir dipivoxil on antiviral efficacy in patients with chronic hepatitis B complicated with fatty liver. Methods 140 patients with chronic hepatitis B admitted to our hospital from January to December 2016 were selected and divided into simple group and combined group according to the randomized list method, 70 cases in each group. Patients with chronic hepatitis B alone were divided into the simple group, and patients with chronic hepatitis B and fatty liver were divided into the combined group. Adefovir dipivoxil antiviral therapy was given to both groups. After 24 weeks, the biochemical, virological and serological responses of the two groups were compared. Results In the simple group, the normal rate of aminotransferase was 72.86%, the negative conversion rate of HBV-DNA was 67.14%, and the negative conversion rate of HBeAg was 57.14%, which were higher than the 55.71%,51.43%, and 38.57% in the combined group, respectively. Among the patients with virological response, the normal rate of aminotransferase in the simple group was 93.62%, which was significantly higher than that of the combined group(66.67%, P<0.05), and the HBeAg negative conversion rate of the simple group and the combined group were 78.72%and 72.22%, respectively, and the difference was not statistically significant(P>0.05). Conclusion Hepatic fat-like lesions have an effect on the antiviral treatment of patients with chronic hepatitis B. Therefore, when antiviral therapy is given to patients with hepatitis B and fatty liver, attention should be paid to the treatment of fatty liver.
Objective To study the effect of adefovir dipivoxil on antiviral efficacy in patients with chronic hepatitis B complicated with fatty liver. Methods 140 patients with chronic hepatitis B admitted to our hospital from January to December 2016 were selected and divided into simple group and combined group according to the randomized list method, 70 cases in each group. Patients with chronic hepatitis B alone were divided into the simple group, and patients with chronic hepatitis B and fatty liver were divided into the combined group. Adefovir dipivoxil antiviral therapy was given to both groups. After 24 weeks, the biochemical, virological and serological responses of the two groups were compared. Results In the simple group, the normal rate of aminotransferase was 72.86%, the negative conversion rate of HBV-DNA was 67.14%, and the negative conversion rate of HBeAg was 57.14%, which were higher than the 55.71%,51.43%, and 38.57% in the combined group, respectively. Among the patients with virological response, the normal rate of aminotransferase in the simple group was 93.62%, which was significantly higher than that of the combined group(66.67%, P<0.05), and the HBeAg negative conversion rate of the simple group and the combined group were 78.72%and 72.22%, respectively, and the difference was not statistically significant(P>0.05). Conclusion Hepatic fat-like lesions have an effect on the antiviral treatment of patients with chronic hepatitis B. Therefore, when antiviral therapy is given to patients with hepatitis B and fatty liver, attention should be paid to the treatment of fatty liver.
引文
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[14]肖春花,利旭辉,张春兰,等.阿德福韦酯治疗慢性乙型肝炎合并非酒精性脂肪性肝病的疗效观察[J].临床肝胆病杂志,2015,31(2):266-268.
[15]王艳玲,张冰,李炳庆,等.阿德福韦酯对乙肝合并脂肪肝疗效分析[J].热带医学杂志,2016,16(10):1272-1274.
[16]吴清华.脂肪肝对干扰素α-2b联合阿德福韦酯治疗慢性乙型肝炎疗效的影响[J].中国实用医药,2016,11(17):152-153.
[2]徐亮,李萍,史琦玉,等.肝脂肪变对聚乙二醇干扰素α-2a治疗慢性乙型肝炎疗效的影响[J].中华肝脏病杂志,2015,23(2):99-102.
[3]刘淑娥,郝美娜,任亚楠,等.慢性乙型肝炎患者合并脂肪肝导致单纯抗病毒治疗生物化学应答不佳诊疗分析[J].中华肝脏病杂志,2015,23(5):333-338.
[4]张天.恩替卡韦联合水飞蓟宾治疗慢性乙型肝炎合并脂肪肝的疗效观察[J].现代消化及介入诊疗,2017,22(4):492-494.
[5]张志侨,王功遂,康凯夫,等.基于216对配对病例研究慢性乙型肝炎患者肝脂肪变性的临床和病理特征[J].中华传染病杂志,2016,34(3):146-150.
[6]许俊,黄敏.拉米夫定联合聚乙二醇干扰素初始和再治疗慢性乙型肝炎合并脂肪肝疗效观察[J].实用肝脏病杂志,2016,19(2):210-211.
[7]王明芳,林苏,吴银莲,等.慢性乙型肝炎患者肝脂肪变性与血清、肝组织病毒因素的关系[J].中华传染病杂志,2016,34(3):141-145.
[8]程乾刚,王亚静,季晓燕,等.非酒精性脂肪性肝病对恩替卡韦治疗慢性乙型肝炎的影响[J].中华临床感染病杂志,2015,(4):348-350.
[9]杨静宁,苏丽环.水飞蓟宾联合核苷(酸)类似物治疗慢性乙型肝炎伴非酒精性脂肪肝的临床疗效观察[J].中国基层医药,2017,24(7):1065-1068.
[10]张志侨,王功遂,康凯夫,等.慢性乙型肝炎患者肝脏脂肪变性的高危人群和预测因素分析[J].临床肝胆病杂志,2015,31(7):1123-1125.
[11]刘素芬,武博荣,刘振中,等.抗病毒治疗慢性乙型肝炎合并非酒精性脂肪肝疗效观察[J].现代中西医结合杂志,2015,(18):1980-1982.
[12]王艳玲,张冰,李炳庆,等.脂肪肝对阿德福韦酯治疗慢性乙型肝炎抗病毒疗效的影响分析[J].重庆医学,2016,45(20):2772-2774.
[13]王婧.拉米夫定联合阿德福韦酯治疗慢性乙型肝炎肝硬化的疗效观察[J].临床和实验医学杂志,2014,13(6):498-500.
[14]肖春花,利旭辉,张春兰,等.阿德福韦酯治疗慢性乙型肝炎合并非酒精性脂肪性肝病的疗效观察[J].临床肝胆病杂志,2015,31(2):266-268.
[15]王艳玲,张冰,李炳庆,等.阿德福韦酯对乙肝合并脂肪肝疗效分析[J].热带医学杂志,2016,16(10):1272-1274.
[16]吴清华.脂肪肝对干扰素α-2b联合阿德福韦酯治疗慢性乙型肝炎疗效的影响[J].中国实用医药,2016,11(17):152-153.