摘要
目的探讨2型糖尿病(T2DM)对慢性丙型肝炎(CHC)患者干扰素联合利巴韦林抗病毒应答效应的影响。方法2017年3月至2019年6月医院诊治的78例CHC合并T2DM患者(研究组)和53例单纯CHC患者(对照组),给予所有患者干扰素联合利巴韦林治疗48周,治疗结束后随访24周。检测治疗前后肝功能指标、胰岛功能指标,比较两组患者抗病毒应答效应,统计药物安全性。结果治疗后两组患者肝功能指标明显改善,两组天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBil)水平对比,差异均无统计学意义(P>0.05)。治疗后研究组空腹血糖(FPG)水平为(5.82±1.03)mmol/L、胰岛素抵抗指数(HOMA-IR)为(2.43±0.40),高于对照组的(5.24±0.91)mol/L、(1.91±0.34),差异具有统计学意义(P<0.05)。治疗后两组的快速病毒学应答(RVR)、早期病毒学应答(EVR)对比差异无统计学意义(P>0.05);研究组治疗结束时病毒学应答(ETVR)、持续病毒学应答(SVR)分别为52.56%、46.15%,均低于对照组的71.70%、66.04%,差异有统计学意义(P<0.05)。治疗期间研究组、对照组药物总不良反应发生率分别为8.97%、7.55%,差异无统计学意义(P>0.05)。结论干扰素联合利巴韦林抗病毒治疗可改善CHC患者肝功能及胰岛功能,且安全性良好,但合并T2DM可影响CHC患者抗病毒治疗的病毒学应答效应。
Objective To explore the effect of comorbid type 2 diabetes mellitus(T2DM)on the antiviral response of interferon combined with ribavirin in the treatment of chronic hepatitis C(CHC)patients.Methods 78 CHC patients with T2DM(study group)and 53 patients with CHC alone(control group)were diagnosed and treated between March 2017 and June 2019.All patients were treated with interferon in combination with ribavirin for 48 weeks and followed up for 24 weeks after the treatment.Indexes of liver and pancreatic islet functions were tested before and after the treatment.The antiviral responses of the two groups of patients were compared,and drug safety was evaluated.Results The liver function indexes of both groups were significantly improved after treatment.There was no statistically significant difference in the levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),and total bilirubin(TBIL)between the two groups(P>0.05).The fasting blood glucose(FPG)level of the study group was(5.82±1.03)mmol/L,and the insulin resistance index(HOMA-IR)was(2.43±0.40)after treatment,which was higher than those of(5.24±0.91)mol/L and(1.91±0.34)respectively in the control group,the difference was statistically significant(P<0.05).There was no significant difference in rapid virological response(RVR)and early virological response(EVR)between the two groups of patients after treatment(P>0.05).However,the virological response at the end of treatment(ETVR)and sustained virological response(SVR)of the study group were 52.56%and 46.15%,respectively,which were lower than those of 71.70%and 66.04%in the control group,the difference was statistically significant(P<0.05).The incidence of total adverse drug reactions of the study group and the control group during the treatment period were 8.97%and 7.55%,respectively,without statistically difference(P>0.05).Conclusion Antiviral therapy with Interferon in combination with ribavirin can improve liver and pancreatic islet functions in CHC patients with good safety,but comorbid T2DM m
作者
胡春霞
杨娇楠
张丰晓
胡敬华
HU Chun-xia;YANG Jiao-nan;ZHANG Feng-xiao;HU Jing-hua(Department of Infection,Zhoukou Central Hospital,Henan 460000,China;Department of Gastroenterology,Zhengzhou people's Hospital,Henan 450003,China)
出处
《肝脏》
2022年第5期553-556,共4页
Chinese Hepatology
基金
河南省医学科技攻关计划项目(编号:LHGJ20191085)。
关键词
2型糖尿病
慢性丙型肝炎
肝功能
胰岛功能
抗病毒应答效应
Type 2 diabetes
Chronic hepatitis C
Liver function
Pancreatic islet function
Antiviral response
