论文部分内容阅读
目的:探讨慢性丙型肝炎(chronic hepatitis C,CHC)合并非酒精性脂肪肝患者的抗病毒疗效及其相关因素的关系.方法:聚乙二醇干扰素联合利巴韦林片治疗共48 wk,观察单纯CHC组患者及CHC合并非酒精性脂肪肝组患者的血脂、胰岛素抵抗指数变化及丙型肝炎病毒(hepatitis C virus,HCV)-RNA阴转情况.结果:治疗前CHC合并非酒精性脂肪肝组患者的胆固醇(5.12 mmol/L±0.93 mmol/L vs3.94 mmol/L±0.75 mmol/L)、低密度脂蛋白(3.95 mmol/L±0.46 mmol/L vs 3.15 mmol/L±0.34 mmol/L)、甘油三酯(3.75 mmol/L±2.27mmol/L vs 1.89 mmol/L±0.52 mmol/L)、谷丙转氨酶(149.30 U/L±26.13 U/L vs 74.50 U/L±25.4 U/L)、血清胰岛素(5.52 mmol/L±1.33mmol/L vs 5.43 mmol/L±0.71 mmol/L)、胰岛素抵抗指数(1.56 mmol/L±0.62 mmol/L vs1.60 mmol/L±0.61 mmol/L)较单纯CHC组明显升高(P<0.01),高密度脂蛋白水平略下降,治疗后HCV-RNA阴转率(40.74%vs 75.75%)较单纯CHC组明显下降(P<0.01).结论:合并非酒精性脂肪肝的CHC患者干扰素抗病毒疗效下降,其原因与胰岛素抵抗有关,通过改善肝脏脂质代谢,可能提高抗病毒疗效.
Objective: To investigate the relationship between antiviral efficacy and its related factors in patients with chronic hepatitis C (CHC) complicated with non-alcoholic fatty liver disease.Methods: Pegylated interferon plus ribavirin tablets were treated for 48 wk , The changes of serum lipids and insulin resistance index and the hepatitis C virus (HCV) -RNA negative conversion in patients with CHC and CHC with non-alcoholic fatty liver were observed.Results: Before treatment, CHC with non-alcoholic The levels of cholesterol (5.12 mmol / L ± 0.93 mmol / L vs 3.94 mmol / L ± 0.75 mmol / L), low density lipoprotein (3.95 mmol / L ± 0.46 mmol / L vs 3.15 mmol / L ± 0.34 triglyceride (3.75 mmol / L ± 2.27 mmol / L vs 1.89 mmol / L ± 0.52 mmol / L), alanine aminotransferase (149.30 U / L ± 26.13 U / L vs 74.50 U / L ± 25.4 Serum insulin (5.52 mmol / L ± 1.33 mmol / L vs 5.43 mmol / L ± 0.71 mmol / L), insulin resistance index (1.56 mmol / L ± 0.62 mmol / L vs1.60 mmol / L ± 0.61 mmol / L) was significantly higher than that of CHC alone group (P <0.01), but the level of HDL decreased slightly. The negative conversion rate of HCV-RNA (40.74% vs 75.75% ) Conclusion: together Interferon in patients with nonalcoholic fatty liver CHC antiviral efficacy decline, its causes associated with insulin resistance, liver by improving lipid metabolism, may enhance the antiviral efficacy.