【摘要】 目的:探讨慢性乙型肝炎(CHB)合并非酒精性脂肪性肝病(NAFLD)对阿德福韦酯抗病毒疗效及对肝纤维化的影响。方法:194例CHB患者分为合并NAFLD组(A组,73例)和未合并NAFLD组(B组,121例),均给予阿德福韦酯(10 mg/d,1次/d)治疗52周。观察两组治疗前后肝功能、病毒学指标及肝纤维化指标的变化。结果:治疗后两组血清AST、ALT指标均显著下降,且B组下降幅度高于A组,差异有统计学意义(P<0.05);B组HBeAg阴转率、HBeAg转换率和HBV-DNA转阴率显著高于A组,差异有统计学意义(P<0.05);两组HA、LN、PCⅢ、CIV水平均较治疗前显著下降,且B组下降幅度高于A组,差异有统计学意义(P<0.05)。结论:合并NAFLD影响CHB患者肝功能恢复和肝纤维化进展,也降低阿德福韦酯抗病毒治疗的应答效应。更多还原

【Abstract】 Objective: To explore the effect on antiviral efficacy of Adefovir Dipivoxil and liver fibrosis in patients with chronic hepatitis B(CHB) by nonalcoholic fatty liver disease(NAFLD). Method: 194 cases of CHB were divided into NAFLD group(group A, 73 cases) and without NAFLD group(group B, 121 cases), all were treated with Adefovir Dipivoxil(10 mg/d, 1/d) for 52 weeks. The changes of liver function, HBV markers and liver fibrosis indexes before and after treatment were observed. Result: After treatment, the serum AST, ALT in the two groups were significantly decreased, and the decreased extent in the group B was higher than that in the group A(P<0.05); the HBeAg negative conversion rate, HBeAg conversion rate and HBV-DNA negative rate in the group B were significantly higher than that in the group A, the difference were statistically significant(P<0.05); the HA, LN, PC Ⅲ, CIV levels of two groups were significantly lower than before treatment, and the decreased extent in the group B was higher than that of the group A, the difference were statistically significant(P<0.05). Conclusion: NAFLD has effects on the progress of liver function recovery and hepatic fibrosis in patients with CHB, and it also reduce the antiviral efficacy of Adefovir Dipivoxil.更多还原