摘要
目的观察合并非酒精性脂肪性肝病(NAFLD)的慢性乙型肝炎(CHB)患者服用富马酸替诺福韦酯(TDF)的疗效,为此类特殊人群的抗病毒治疗提供循证依据。方法回顾性分析91例服用TDF 300 mg/d抗病毒治疗96周的CHB患者资料,其中合并NAFLD的患者43例为研究组,无NAFLD的CHB患者48例为对照组,比较两组患者在治疗12、24、48、96周的病毒学应答及生物化学应答情况。其中69例患者进行了HBV DNA高灵敏检测。对数据进行t检验、χ^(2)检验。结果治疗12、24周时,研究组患者丙氨酸转氨酶复常率(42%、51%)低于对照组(69%、79%),差异有统计学意义(P值均<0.05);在48、96周时两组间差异无统计学意义。HBV DNA低于检测下限(200 IU/ml)的发生率在治疗12周时研究组低于对照组(35%与56%),差异有统计学意义(P<0.05);而在24、48、96周时两组间的差异无统计学意义。而HBV DNA检测下限以20 IU/ml为标准时,在治疗12、24、48、96周时,研究组HBV DNA低于检测下限的发生率均明显低于对照组,差异有统计学意义(P值均<0.05)。HBeAg血清学阴转率均逐渐升高,在治疗48、96周时研究组均较对照组偏低,但差异无统计学意义。结论在CHB的抗病毒治疗中,NAFLD可影响TDF的病毒学应答及生物化学应答。
Objective To observe the efficacy of tenofovir disoproxil fumarate(TDF)antiviral therapy in patients with chronic hepatitis B(CHB)combined with nonalcoholic fatty liver disease(NAFLD),so as to provide evidence-based evidence in these special populations.Methods Data from 91 CHB cases who received TDF 300 mg/d antiviral therapy for 96 weeks were analyzed retrospectively.Among them,43 cases with NAFLD were included in the study group,and 48 cases without NAFLD were included in the control group.The virological and biochemical responses of the two groups of patients at 12,24,48,and 96 weeks were compared.Among them,69 patients underwent highly sensitive detection of HBV DNA.The t-test andχ^(2) test were performed on the data.Results ALT normalization rate was lower in the study group(42%,51%)at 12 and 24 weeks of treatment than that in the control group(69%,79%),and the difference was statistically significant(P<0.05).However,there was no statistically significant difference between the two groups at 48 and 96 weeks.HBV DNA concentration below the lower limit of detection(200 IU/ml)was lower in the study group at 12 weeks of treatment than in the control group(35%vs.56%),and the difference was statistically significant(P<0.05).However,there was no statistically significant difference between the two groups at 24,48,and 96 weeks.Furthermore,HBV DNA concentration below the lower limit was significantly lower in the study group than that in the control group at 12,24,48,and 96 weeks of treatment when the lower limit of HBV DNA detection was set at 20IU/ml,and the difference was statistically significant(P<0.05).The HBeAg serological negative conversion rate was gradually higher in the study group at 48 and 96 weeks of treatment than in the control group,and the difference was not statistically significant.Conclusion TDF antiviral treatment can affect the virological and biochemical responses of NAFLD in chronic hepatitis B.
作者
梁尘格
王茜
刘书宏
石小枫
Liang Chenge;Wang Xi;Liu Shuhong;Shi Xiaofeng(Institute for Viral Hepatitis,Department of Infectious Diseases,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China;Hepatology Department,Chongqing University Three Gorges Hospital,Chongqing 404100,China)
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2023年第2期113-117,共5页
Chinese Journal of Hepatology
