健肝降脂丸联合干扰素治疗慢性乙型肝炎合并非酒精性脂肪肝的疗效观察

摘要

Objective To discuss the clinical features of HbeAg-negative chronic hepatitis B patients associate with non-alcoholic fatty liver disease (NAFLD), to value the effect of combining treatment on fatty liver influence and antivi-ral therapy. Methods Nighty eight chronic hepatitis B patients with non-alcoholic fatty liver disease (NAFLD) (Liver pa-thology G≥2 or S≥2,HBV DNA>1 × 105 copies/mL), were observed and given antiviral therapy with interferon alpha 1 b for 24 weeks. These patients were divided into combined treatment group (55 cases treated with interferon alpha 1 b combined with Jian Gan Jiang Zhi pills) and control group (43 cases treated with interferon alpha 1 b) in accordance with random num-ber table. All these patients took Leucoson to prevent blood cells reduction. The combined treatment effect was analyzed by observing and comparing biochemical serum change and HBV DNA negative conversion ratio between two groups. Re-sults After 24 weeks of antiviral therapy in Chronic hepatitis B patients with negative HBeAg associated with NAFLD, ALT and AST decreased significantly in both treatment group and control group. And this change is more obvious in treat-ment group than in control group. TC and TG in treatment group and TC in control group were also dropped with treatment (P<0.05). There is significant difference on HBV DNA negative conversion ratio between treatment groupand control group (98.2%vs 86.0%,P<0.05). Conclusion The combination of antiviral treatment and anti fatty liver treatment can obviously improve liver function and blood lipids, increase negative conversion ratio of HBV DNA for chronic hepatitis B patients asso-ciated with NAFLD.%目的：探讨慢性乙型肝炎（慢乙肝）合并非酒精性脂肪肝（NAFLD）的临床特点，抗病毒联合脂肪肝治疗对其疗效的影响。方法以98例慢乙肝合并NAFLD患者（肝脏病理G≥2且S≥2，HBV DNA>1×105 copies/mL）为观察对象，给予干扰素α-1b抗病毒治疗24周。按随机数字表法分为联合组（干扰素α-1b联合健肝降脂丸）55例和对照组（单用干扰素α-1b）43例，并均应用利可君预防白细胞减少。观察2组血清生化指标改变，HBV DNA阴转率，分析应用健肝降脂丸治疗对干扰素α-1b抗病毒治疗的影响。结果合并NAFLD的慢乙肝患者经过24周抗病毒治疗，联合组与对照组ALT和AST均明显降低，治疗后联合组ALT低于对照组，治疗后联合组TC、TG及对照组TC均较治疗前降低（均P<0.05）。联合组HBV DNA阴转率优于对照组（98.2%vs 86.0%，P＜0.05）。结论抗病毒联合抗脂肪肝治疗能明显改善慢乙肝合并NAFLD患者肝功能及血脂指标，提高HBV DNA阴转率。