血脂水平与慢性丙型肝炎患者抗病毒疗效的相关性分析

• Main Author: SHI Jia
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2014-06-01
• Series: Linchuang Gandanbing Zazhi
• Subjects: hepatitis C; chronic; hepatitis C virus; trigly cerides; cholesterol; pegylated interferon; ribavirin
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=5810&ClassID=42414109
• ISSN: 1001-5256; 1001-5256

ObjectiveTo investigate the association between serum lipid levels and antiviral treatment outcome in chronic hepatitis C (CHC) patients. MethodsA total of 171 treatment-naive CHC patients were included in the present retrospective study and received a standard therapy of pegylated interferon (PEG-IFN) plus ribavirin. Serum levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A (apoA), apolipoprotein B (apoB), and other vital indicators in laboratory were determined, and their relationships with treatment responses, hepatitis C virus (HCV) genotypes, and therapy time points (for non-1b type, 0, 12, and 24 weeks; for 1b type, 0, 24, and 48 weeks) were analyzed. For normally distributed measurement data, values were expressed as mean ± SD, and statistical analysis was performed by t test and ANOVA; for non-normally distributed data, values were expressed as median and interquartile range, and statistical analysis was performed by rank sum test; for categorical variables, values were expressed as frequency (constituent ratio), and statistical analysis was performed by chi-square test. Univariate and multivariate logistic regression analyses were performed to determine prognostic factors. ResultsAmong the 171 CHC patients receiving PEG-IFN plus ribavirin, 81.87% achieved a sustained virological response (SVR), and 18.13% did not; SVR patients showed significantly lower TG and apoB levels than non-SVR patients (P＜0.05). Compared with patients infected with HCV-1b and HCV-6a, those with HCV-3 infection had lower serum levels of TC, LDL-C, apoA, and apoB (P＜0.05), while the opposite results were observed in terms of the levels of alanine aminotransferase and aspartate aminotransferase (P＜0.05). In the SVR group, significant increases in TG and apoB were observed at the end of treatment process, while a significant decrease in HDL-C was also noted (P＜005). However, no significant changes in serum lipids were observed in non-SVR patients. The univariate logistic regression analysis revealed that SVR was closely related to the following factors: age ≤50 years, HCV genotype non-1b, TG ≤3.11 mmol/L, and apoB ≤063 g/L (P＜0.05). The multivariate logistic regression analysis indicated that patients with CHC were more likely to achieve a SVR if they were ≤50 years old with a serum apoB level of ≤0.63 g/L. ConclusionSerum lipid levels and age are closely related to the clinical outcome of CHC. Age (≤50 years) and serum apoB level (≤0.63 g/L) are two independent predictors for SVR in CHC patients.