| 摘要: |
| ［摘要］ 目的 探讨恩替卡韦治疗非酒精性脂肪性肝病合并慢性乙型肝炎的疗效及对胰岛素抵抗的影响。方法 对2012-08～2015-08该院诊治的65例非酒精性脂肪性肝病合并慢性乙型肝炎患者应用恩替卡韦治疗（观察组），将同期接受相同治疗方式的58例单纯慢性乙型肝炎患者作为对照（对照组），分析两组治疗12个月后血清谷丙转氨酶（ALT）复常率、病毒学应答以及胰岛素抵抗情况。结果 治疗后，两组ALT水平显著下降，且对照组下降幅度显著高于观察组（P<0.01）；观察组ALT复常率（52.31%）低于对照组（72.41%）（P<0.05）。观察组乙肝病毒定链（HBV-DNA）拷贝量显著高于对照组（P<0.01），HBV-DNA阴转率显著低于对照组（P<0.05）。两组空腹血糖（FPG）、空腹胰岛素（FINS）和胰岛素抵抗（HOMA-IR）均显著下降，且对照组下降幅度显著高于观察组（P<0.05或P<0.01）。结论 非酒精性脂肪性肝病可影响恩替卡韦治疗慢性乙型肝炎疗效，乙肝治疗过程应注重脂肪肝对症治疗。 |
| 关键词: 非酒精性脂肪性肝病 慢性乙型肝炎 恩替卡韦 胰岛素抵抗 |
| DOI：10.3969/j.issn.1674-3806.2017.07.17 |
| 分类号:R 512.6+2 |
| 基金项目: |
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| Effect of non-alcoholic fatty liver disease on entecavir in treatment of chronic hepatitis B and insulin resistance |
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JIANG Jin-yan
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The Fourth Department of Liver Diseases, the Third People′s Hospital of Shenzhen, Guangdong 518000, China
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| Abstract: |
| ［Abstract］ Objective To study the effect of non-alcoholic fatty liver disease(NAFLD) on entecavir in the treatment of chronic hepatitis B(CHB) and insulin resistance.Methods From August 2012 to August 2015, a total of 65 patients with NAFLD complicated with CHB in our hospital were collected as the observation group, and during the same period other 58 patients with CHB were taken as the control group. Both of the two groups were given entecavir for 12 months. After the treatment, the recovery rate of alanine aminotransferase, virological response and insulin resistance were compared between the two groups.Results After the treatment, the levels of ALT in both of the two groups were significantly decreased, and the control group had more reduction（P<0.01）. The recovery rate of ALT in the observation group(52.31%) was lower than that in the control group(72.41%)（P<0.05）. The HBV-DNA copy numbers in the observation group were significantly higher than those in the control group, and the negative conversion rate of HBV-DNA in the observation group was significantly lower than that in the control group（P<0.05）. The FPG, FINS and HOMA-IR were significantly decreased in both of the two groups, and the control group had more reduction（P<0.05 or P<0.01）.Conclusion NAFLD is a risk factor influencing the effect of entecavir in the treatment of CHB, therefore, symptomatic treatment of fatty liver should be given to the patients in the treatment of hepatitis B. |
| Key words: Non-alcoholic fatty liver disease(NAFLD) Chronic hepatitis B(CHB) Entecavir Insulin resistance |
