脂类代谢对慢性丙型肝炎抗病毒治疗疗效的影响

Influence of lipid metabolism on the antiviral response in patients with chronic hepatitis C

目的探讨脂类代谢与慢性丙型肝炎抗病毒治疗疗效的关系。方法收集本院收治的51例慢性丙型肝炎患者的临床资料,应用实时荧光定量PCR(FQ-PCR)方法检测患者血清HCV RNA载量,应用全自动生物化学分析仪检测患者外周血甘油三酯和总胆固醇水平。取肝脏组织进行HE染色病理学分析。分析脂类代谢指标和抗丙型肝炎病毒持续病毒学应答(SVR)的相关性。结果 18例(35.3%)慢性丙型肝炎患者合并脂肪肝,其中大泡型7例(38.9%),小泡型2例(11.1%),混合型9例(50.0%)。慢性丙型肝炎合并脂肪肝组和不合并脂肪肝组患者HCV RNA载量和SVR率比较差异均具有统计学意义,脂肪肝组患者的HCV RNA载量和SVR率均低于非脂肪肝组患者(P<0.05)。根据病毒学应答情况分组,SVR组和无应答组(NR)患者血浆TG水平的差异具有统计学意义,SVR组慢性丙型肝炎患者的血浆TG水平低于NR组(P<0.05)。结论慢性丙型肝炎合并脂肪肝和高TG水平可能和慢性丙型肝炎抗病毒治疗的持续应答率降低有关。

Objective To investigate the relationship among plasma lipid level, antiviral response and liver histological steatosis in patients with chronic hepatitis C （CHC）. Methods Fluorescent quantitative polymerase chain reaction （FQ-PCR） was applied to detect the levels of serum HCV RNA in 51 patients with chronic hepatitis C. The levels of plasma TG and CHO were measured by biochemical instrument. Liver biopsy was performed in 51 patients and histopathological changes were observed by HE staining under light microscope. Results There were 18 cases among 51 CHC patients had liver steatosis. There were significant difference in sustained virological response （SVR） rate and levels of serum HCV RNA between CHC patients with liver steatosis and no liver steatosis which were higher in the former patients than the latter （P0.05）. The levels of plasma TG in SVR group were lower than that of no response （NR） group （P 0.05）. Conclusions The level of plasma TG and liver steatosis were probably related to SVR rate in patients with CHC.