接受抗病毒治疗的慢性乙型肝炎患者非酒精性脂肪性肝病的患病率及其危险因素分析

Prevalence and risk factors of nonalcoholic fatty liver disease in patients with chronic hepatitis B receiving antiviral therapy

目的调查正在接受抗病毒治疗的慢性乙型肝炎(CHB)患者非酒精性脂肪性肝病(NAFLD)的患病率并分析其危险因素。方法横断面研究,总共纳入分析3477例正在接受抗病毒治疗的CHB患者。研究调查NAFLD的患病率,然后以CHB患者是否合并NAFLD作为因变量,相关影响因素作为自变量,采用逐步回归法筛选和分析危险因素。结果接受抗病毒治疗的CHB患者中,NAFLD的患病率为24.1%。校正年龄和性别后,中心性肥胖[比值比(OR):7.44,95%可信区间(CI):6.06~9.14]、高血压(OR:1.52,95%CI:1.18~1.96)、甘油三酯水平(OR:1.74,95%CI:1.51~2.20)与NAFLD呈正相关,肝硬化(OR:0.42,95%CI:0.34~0.53)与NAFLD呈负相关。抗病毒治疗时间越长,NAFLD患病风险随之增加。结论NAFLD在接受抗病毒治疗的CHB患者中并不少见。接受长期抗病毒治疗的CHB患者应更警惕NAFLD的发生。

Objective To investigate the prevalence and risk factors of non-alcoholic fatty liver disease(NAFLD)in patients with chronic hepatitis B(CHB)receiving antiviral treatment.Methods The cross-sectional study included 3 477 cases with CHB who received antiviral therapy.The prevalence of NAFLD was investigated,and then the risk factors were screened and analyzed by stepwise regression method in CHB patients with NAFLD as the dependent variable and the related influencing factors as independent variables.Results The prevalence of NAFLD was 24.1% in CHB patients who received antiviral therapy.After adjusting for age and gender,central obesity(OR:7.44,95% CI:6.06~9.14),hypertension(OR:1.74,95% CI:1.51~2.20),and triglyceride(OR:1.52,95% CI:1.18~1.96)were positively associated with NAFLD,and cirrhosis was negatively associated with NAFLD(OR:0.42,95% CI:0.34~0.53).Patients with long-term antiviral therapy had increased risk of NAFLD.Conclusion A significant proportion of CHB patients receiving antiviral therapy have suffered from NAFLD.Therefore,CHB patients receiving long-term antiviral treatment should pay more attention to the prevalence of NAFLD.