胰岛素抵抗对干扰素治疗慢性丙型肝炎疗效影响

摘要

Objective To investigate the impact of insulin resistance( IR ) on the clinical efficacy of interferon for treating patients with chronic hepatitis C. Methods Sixty - six patients with chronic hepatitis C were divided into two groups, the observation group had 34 patients with IR, another 32 patients without IR were as control group. All patients received combination therapy with peg -interferon α -2a ( PEG - IFNα -2a )and ribavirin, and the clinical efficacy was compared between the two groups, and then the correlation between IR and the efficacy was analyzed. Results There were no significant difference in complete response rate between the two groups( P >0. 05 ); However, there were significant differences in sustained response rate and effective rate between the two groups ( P < 0. 05 ); Insulin levels and homeostatic model assessment of insulin resistance ( HO MA - IR ) of effective group in the observation group were significantly lower than that of the ineffective group ( P < 0. 05 ), and IR was correlated with clinical efficacy( r = 2. 054 ,P < 0. 05 ). Conclusion The patients with chronic hepatitis C and IR have less curative effect than the patients without IR in the interferon anti - viral therapy, and IR is an important factor that effects the efficacy of interferon, which suggests that it can enhance the antiviral response and achieve better clinical efficacy by IR improvement.%目的 探讨胰岛素抵抗(insulin resistance,IR)对于干扰素治疗慢性丙型肝炎临床疗效的影响.方法 66例患者分为观察组34例,对照组32例,观察组为有IR的慢性丙型肝炎患者,对照组为无IR的慢性丙型肝炎患者,所有患者均采用聚乙二醇干扰素α-2a(peginterferon alfa-2a,PEG-IFNα-2a)联合利巴韦林治疗.比较2组患者的临床疗效,分析IR与疗效之间的关系.结果 观察组和对照组的完全应答率差异无统计学意义(P>0.05),但2组之间的持续应答率和有效率差异有统计学意义(P＜0.05),观察组中治疗有效组的胰岛素水平和胰岛素抵抗指数明显低于无效组(P＜0.05),IR与疗效具有相关性(r=2.054,P＜0.05).结论 干扰素抗病毒治疗有IR的慢性丙型肝炎患者相对于无IR的患者疗效较差,且IR是影响干扰素疗效的重要因素之一,提示改善IR可以提高抗病毒应答,可取得更好的临床疗效.