摘要
目的:分析胰岛素抵抗(IR)对干扰素治疗慢性乙型肝炎(CHB)疗效的影响.方法:选取2014-08/2015-06在河南省郑州市第六人民医院感染科采取干扰素治疗CHB的患者78例,根据有无IR分为研究组(n=39,胰岛素抵抗组)和对照组(n=39,无胰岛素抵抗组),所有患者均采取干扰素(聚乙二醇干扰素α-2a)与恩替卡韦联用的治疗方案进行治疗,均在HBeAg出现转换后考虑单药方案,观察和记录两组的疗效并对结果进行分析.结果:两组在治疗期间及治疗结束即48周时的血清ALT水平正常率、HBeAg转换率与HBV-DNA转阴率比较,差异无统计学意义(P>0.05),但在治疗结束后24周随访期间,研究组血清ALT正常率与HBV-DNA转阴率均低于对照组,差异具有统计学意义(P<0.05).结论:IR是影响干扰素远期疗效的因素之一,存在IR的患者其治疗结束后随访期间疗效较差,这提示在临床工作中应关注CHB患者有无IR的存在,若存在IR,则改善CHB患者的IR可增加抗病毒治疗的疗效收益.
AIM： To analyze the effect of insulin resistance on the efficacy of interferon in the treatment of chronic hepatitis B （CHB）. METHODS： A total of 78 patients with CHB treated with interferon admitted into Department of Infectious Diseases of the Sixth People＇s Hospital of Zhengzhou from August 2014 to June 2015 were selected as the objects of study. The patients were divided into study group （ n = 39 ） and control group （ n = 39 ）. Patients in the study group had insulin resistance, while the con- trol group had no insulin resistance. All patients were treated with interferon （ peginterferon ct-2a） and entecavir in combination. The monotberapy program was taken into consideration when HBeAg began to transition, and the efficacy and the results of two groups were observed and recorded. RESULTS： There were no signifi- cant differences in normal rate of serum ALT level, HBeAg con- version rate and HBV-DNA negative rate between the study group and the control group during and after treatment （ at the end of 48 weeks） （P〉0.05） ; During the 24 weeks of follow-up visit after treatment, the normal rate of serum ALT level and HBV-DNA negative rate were lower than the control group, and the differ- ences were statistically significant （ P〈 0.05 ）. CONCLUSION ： Insulin resistance is one of the factors that affect the long-term efficacy of interferon. Patients with insulin resistance have poor curative effect during the follow-up period after treatment. This suggests that we should pay attention to the presence or absence of insulin resistance in patients with chronic hepatitis B in the clini- cal work, if there is insulin resistance, the improvement of CHB patients with insulin resistance can increase the efficacy of antivi- ral therapy benefits.
作者
王佳乐
李广明
赵小丽
WANG Jia-Le LI Guang-Ming ZHAO Xiao-Li(Sixth People＇s Hospital of Zhengzhou, Zhengzhou 450000, Chin)
出处
《转化医学电子杂志》
2017年第6期46-48,共3页
E-Journal of Translational Medicine
基金
郑州市普通科技攻关计划项目(131PPTGG383-1)
关键词
胰岛素抵抗
慢性乙型肝炎
干扰素
insulin resistance
chronic hepatitis B
interferon
