非活动性HBV携带者服用不同他汀类药物的安全性

摘要

目的 探讨非活动性HBV携带者服用不同他汀类药物的安全性.方法 选择合并高脂血症或动脉粥样硬化性心血管疾病需要服用他汀类药物治疗的非活动性HBV携带者46例,随机分为瑞舒伐他汀组及阿托伐他汀组各23例,并给予相应的常规剂量药物治疗.于治疗前及治疗6个月后比较两组患者HBV-DNA及肝功能水平,观察治疗期间有无乙型肝炎发作.结果 治疗期间两组均未见乙型肝炎发作及ALT水平大于正常值上限3倍的患者.在治疗前后,两组间HBV-DNA、总胆红素及ALT水平比较,差异均无统计学意义(P>0.05).治疗后,各组内HBV-DNA、总胆红素及ALT水平与治疗前比较,差异均无统计学意义(P>0.05).结论 非活动性HBV携带者服用常规剂量的他汀类药物治疗是安全的,不会诱发体内HBV-DNA的复制增加或肝炎发作,也不会增加药物性肝损伤的发生,不同类他汀药物之间无明显差异.%Objective To investigate the safety of oral administration of different statins in inactive HBV carriers. Methods Forty-six inactive HBV carriers were enrolled and received the oral administration of statins due to complication of hyperlipidemia or atherosclerotic cardiovascular disease. The patients were randomly divided into rosuvastatin group and atorvastatin group,with 23 cases in each group,and received corresponding medicine of conventional therapeutic dose. Before treatment and at 6 months after treatment,the levels of HBV-DNA and liver function were compared between the two groups. Hepatitis B attack was observed during the treatment. Results During the treatment, no patients with hepatitis B attack or ALT level more than 3 times upper limit of normal level were found. Before and after treatment,there were no significant differences in the level of HBV-DNA,total bilirubin or ALT between the two groups(P>0. 05). In each group,the level of HBV-DNA,total bilirubin or ALT showed no significant changes after treatment compared to the levels before treatment(P>0. 05). Conclusion Oral administration of statins with conventional dose is safe for inactive HBV carriers. This therapy will not induce the increase of HBV-DNA replication or hepatitis attack,or increase the incidence of drug-induced liver damage. And there is no significant difference between different types of statins.