脂肪肝对HBeAg阳性慢性乙型肝炎患者疗效影响.docVIP

脂肪肝对HBeAg阳性慢性乙型肝炎患者疗效影响 　　[摘要]目的 探?脂肪肝对HBeAg阳性慢性乙型肝炎（CHB）患者应用阿德福韦酯抗病毒疗效的影响及其对于HBsAg预测抗病毒疗效价值的影响。方法 选择2012年1月～2014年12月在该院门诊就诊的71例e抗原阳性CHB患者为研究对象，其中40例为单纯乙肝组，乙肝合并非酒精性脂肪肝（NAFID）31例为乙肝合并脂肪肝组。两组患者均给予阿德福韦酯10 mg/d口服抗病毒治疗24周及36周，观察两组HBV-DNA阴转率（完全病毒学应答）有无差异。根据是否获得病毒学应答将单纯乙肝组及乙肝合并脂肪肝组分别分为完全病毒学应答组及无应答组，分别观察两组中的两亚组患者HBV-DNA、HBsAg在治疗过程中的变化趋势。结果 乙肝合并脂肪肝组在治疗24、36周HBV-DNA阴转率分别为48.4%和61.3%，显著低于单纯乙肝组的75.0%、82.5%，差异有统计学意义（P0.05）。结论 合并脂肪肝影响乙型肝炎患者的HBV-DNA阴转率；乙肝合并脂肪肝时，HBsAg定量值变化不能反映治疗后病毒学应答情况 [关键词]阿德福韦酯；非酒精性脂肪肝；慢性乙型肝炎 [中图分类号] R512.6+2 [文献标识码] A [文章编号] 1674-4721（2016）11（c）-0023-04 [Abstract]Objective To investigate the impact of fatty liver on antiviral efficacy of Adefovir dipivoxil and the HBsAg′s predictive value in chronic hepatitis B （CHB） patients with e antigen （HBeAg） positive.Methods 71 CHB patients with HBeAg positive in the hospital outpatient clinic from January 2012 to December 2014 were selected as study subjects，among which，40 cases were simple hepatitis B group，31 cases of hepatitis B with nonalcoholic fatty liver disease （NAFID） were hepatitis B with fatty liver group.Patients of two groups were given oral Adefovir dipivoxil 10 mg/d antiviral therapy for 24 weeks and 36 weeks，negative conversion rate （complete virological response） of HBV-DNA in two groups were observed.According to whether or not to obtain a viral response，simple hepatitis B group and hepatitis B with fatty liver group were divided into complete viral response group and non response group，the change trends of HBV-DNA and HBsAg of two subgroups in two groups were respectively observed in the treatment process.Results After treatment for 24 weeks and 36 weeks，HBV-DNA negative conversion rate in the hepatitis B with fatty liver group was 48.4% and 61.3% respectively，significantly lower than 75.0%，82.5% in the simple hepatitis B group，and the difference was statistically significant （P0.05）.Conclusion HBV-DNA negative conversion rate in patients with hepatitis B can be influenced by complicated with