论文部分内容阅读
目的研究非酒精性脂肪性肝病(NAFLD)是否会影响阿德福韦酯(ADV)的抗病毒疗效。方法研究纳入105例诊断符合慢乙肝(CHB)标准,其中49例合并NAFLD的患者。所有患者均口服国产阿德福韦酯治疗。比较两组在24、48、96周时e Ag转换率、HBVDNA清除率、ALT复常率的差异。分析影响HBVDNA清除和ALT复常的因素,研究体重指数(BMI)、腰围、腰臀比、FBG是否影响CHB患者的生化学、病毒学应答。结果合并NAFLD组在24、48、96周时的HBVDNA清除率、ALT复常率均低于单纯CHB组(P<0.05);e Ag转换率两组差异无统计学意义;ALT复常组与ALT不复常组比较,两组间BMI、腰围、腰臀比、空腹血糖(FBG)差异有统计学意义,CHB合并NAFLD组明显高于单纯CHB组;分析影响病毒学应答因素时,得出同样结果,即BMI、腰围、腰臀比、FBG也是影响病毒学应答的危险因素。结论 NAFLD是影响ADV抗病毒疗效的独立危险因素,合并NAFLD的CHB患者服用ADV,疗程可能需延长;与NAFLD息息相关的因素BMI、腰围、腰臀比、FBG也影响CHB患者的生化学及病毒学应答。
Objective To investigate whether non-alcoholic fatty liver disease (NAFLD) affects the antiviral efficacy of adefovir dipivoxil (ADV). Methods We enrolled 105 patients diagnosed with chronic hepatitis B (CHB) criteria, including 49 with NAFLD. All patients oral oral adefovir dipivoxil treatment. The differences of e Ag conversion rate, HBVDNA clearance rate and ALT normalization rate between the two groups at 24, 48 and 96 weeks were compared. To analyze the factors influencing the clearance of HBVDNA and ALT, and to study whether the body mass index (BMI), waist circumference, waist-hip ratio (FBG) and FBG affect the biochemical and virological response of CHB patients. Results The HBVDNA clearance rate and ALT normalization rate in the NAFLD group at 24, 48 and 96 weeks were both lower than those in the CHB group (P <0.05). There was no significant difference in eAg conversion between the two groups There were significant differences in BMI, waist circumference, waist-hip ratio, fasting blood glucose (FBG) between CHB group and NAFLD group compared with those in CHB group and ALT group. In the analysis of influencing factors of virological response, The same result, that BMI, waist circumference, waist-hip ratio, FBG is also a risk factor affecting the virological response. Conclusions NAFLD is an independent risk factor for ADV antiviral therapy. CHB patients with NAFLD may take prolonged course of AD treatment. The factors associated with NAFLD such as BMI, waist circumference, waist-hip ratio, and FBG also affect the biochemistry and virology of CHB patients answer.