摘要
目的探讨以蛋白酶抑制剂(PIs)或非核苷类反转录酶抑制剂(NNRTIs)为主方案治疗HCV/HIV合并感染者,对患者丙型肝炎疾病进展的影响。方法收集初次就诊的273例HCV/HIV合并感染者为研究对象。分别用PIs(PIs组,135例)或NNRTIs(NNRTIs组,138例)为主的方案治疗1年。实验室检查治疗前、后HCV RNA、AST、ALT、TBil、白蛋白(Alb)、层粘连蛋白(LN)、甘胆酸(CG)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)、凝血酶原活动度(PTA)、胆碱酯酶(ChE)等指标。计量资料经Kolmogorov-Smirnov检验,非正态分布数据采用Mann Whitney U检验。结果治疗后NNRTIs组PTA、ChE、TBil、Alb、ALT、AST、CG、LN显著高于PIs组。PTA分别是77%(67%,109%)和68%(56%,91%);ChE分别是6717.00(5951.00,7622.00)和5862.00(4392.00,8539.25)U/L;TBil分别是10.95(8.10,14.32)和8.60(8.00,9.50)μmol/L;Alb分别是43.90(39.65,48.20)和38.90(36.00,45.00)mmol/L;ALT分别是52.50(30.00,93.50)和36.20(30.30,40.40)U/L;AST分别是49.00(33.00,80.00)和31.30(29.70,38.70)U/L;CG分别是16.78(3.26,29.32)和3.26(1.02,6.88)μg/ml;LN分别是34.40(16.71,46.54)和34.05(33.42,64.33)ng/ml,两组比较差异有统计学意义(P<0.05或P<0.01)。结论 NNRTIs为主治疗HCV/HIV合并感染的患者可以加重其丙型肝炎进展。
Objective To investigate the effect of protease inhibitors (PIs) - or non - nucleoside reverse transcriptase inhibitors ( NNR- TIs) -based therapy on the progression of hepatitis C in patients with hepatitis C virus (HCV)/human immunodeficiency virus (HIV) coin- fection. Methods A total of 273 patients initially diagnosed with HCV/HIV eoinfection were enrolled and divided into PIs group ( n = 135 ) and NNRTIs group (n = 138 ) to receive PIs- based therapy and NNRTIs -based therapy, respectively, for one year. Laboratory indices, such as HCV RNA, aspartate aminotransferase (AST) , alanine aminotransferase (ALT) , total bilirubin (TBil) , albumin (Alb) , laminin (LN), cholyglycine (CG), type III procollagen (PCIII), type IV collagen (CIV), prothrombin activity (PTA), and cholinesterase (CHE) , were quantified before and after treatment. The obtained data were analyzed using sPss 11.5 software ; enumeration data were ana- lyzed using the Kolmogorov - Smirnov test, and non - normal data were analyzed using the Mann - Whitney U test. Results After the end of treatment, PTA, CHE, TBil, Alb, ALT, AST, CG, and LN levels were significantly higher in NNRTIs group than in PIs [PTA: 77% (67% -109%) vs68% (56% -91%) ; CHE: 6717.00 U/L (5951.00 -7622.00 U/L) vs 5862.00 U/L (4392.00 -8539.25 U/L) ; TBil : 10.95 p, mol/L ( 8.10 - 14.32 p, moL/L) vs 8.60 p^mol/L ( 8.00 - 9.50 μmol/L) ; Alb : 43.90 mmol/L ( 39.65 - 48.20 mmol/L) vs 38.90 mmol/L (36.00 -45.00 mmol/L) ; ALT: 52.50 U/L (30.00 -93.50 U/L) vs 36.20 U/L (30.30 -40.40 U/L) ; AST: 49.00 U/L (33.00 - 80.00 U/L) vs 31.30 U/L (29.70 - 38.70 U/L) ; CG: 16.78 μg/ml ( 3.26 - 29.32 μg/ml) vs 3.26 μg/ml ( 1.02 - 6. 88 μg/ml) ; LN : 34.40 ng/ml ( 16.71 - 46.54 ng/ml) vs 34.05 ng/ml ( 33.42 - 64.33 ng/ml) ; P 〈 0.01 or P 〈 0.05 ]. Conclusion NNRTIs - based therapy can accelerate the progression of hepatitis C in HCV/HIV - coinfeeted patients.
出处
《临床肝胆病杂志》
CAS
2013年第11期835-838,共4页
Journal of Clinical Hepatology