慢性乙型肝炎合并脂肪肝对替比夫定疗效的影响

Influence of chronic hepatitis B complicated with hepatic steatosis to response of telbivudine therapy

目的了解慢性乙型肝炎合并脂肪肝病人对替比夫定抗乙型肝炎病毒疗效的影响。方法回顾分析128冽使用替比夫定抗乙型肝炎病毒治疗慢性乙型肝炎病人的肝组织病理检查，分为慢性乙型肝炎合并脂肪肝组43例，男性32例，女性11例，年龄（36±s16）岁；单纯慢性乙肝组85例，男性62例，女性23例，年龄（37±11）岁。结果替比夫定抗病毒治疗1年丙氨酸转移酶（ALT）复常率2组分别为60％和84％（X^2=5．892，P〈0．01），乙肝病毒脱氧核糖核酸（HBVDNA）转阴率分别为70％和86％（X^2=5．135，P〈0．01）。盱穿病理结果存在肝细胞脂肪变性的慢性乙型肝炎病人对于替比夫定抗乙型肝炎病毒的ALT复常率和HBVDNA转阴率下降。结论肝细胞脂肪变性是影响替比夫定抗病毒疗效的重要因素之一。

AIM To study the effects of chronic hepatitis B complicated with fatty liver on the response to telbivudine anti-hepatitis B virus therapy. METHODS This is a restrospective analysis of the clinical data and pathologic study of liver biopsy from 128 chronic hepatitis B patients treated with telbivudine anti-hepatitis B virus. Forty-three chronic hepatitis B patients complicated with fatty liver were included in A group, consisting of 32 male, 11 famale, and average age of （36± s 6） ; and 85 another patients without fatty liver in B group of 62 male patients and 23 famale and average age of （37 ±11 ） . RESULTS After one year treatment with telbivudine, the percent of alanine aminotransferase （ALT） returning to normal and HBV DNA transforming to negative in A and B group were 60 % and 84 % （X^2 =5.892, P〈0.01）, and 70% and 86 % （X^2=5.315, P 〈 0.01） , respectively. We identified the percent ages of biochemical response and virological response to telbivudine therapy were definitely decreased in patients with chronic hepatitis B complicated with fatty liver via liver biopsy. CONCLUSION The liver cell fatty change may be an important determinant of telbivudine antiviral response.