代谢综合征对慢性乙型肝炎患者核苷类似物治疗临床疗效的

StephenW

Digestive Diseases and Sciences

October 2018, Volume 63, Issue 10, pp 2792–2799 | Cite as
Effect of Metabolic Syndrome on the Clinical Outcomes of Chronic Hepatitis B Patients with Nucleos(t)ide Analogues Treatment

    Authors
    Authors and affiliations

    Nam Hee KimYong Kyun ChoByung Ik KimHong Joo KimEmail author

    Nam Hee Kim
        1
    Yong Kyun Cho
        2
    Byung Ik Kim
        2
    Hong Joo Kim
        2Email authorView author's OrcID profile

    1.Preventive Healthcare Center, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulKorea
    2.Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulKorea

Original Article
First Online: 12 June 2018

    109 Downloads

Abstract
Background

No data are available about the effect of MS on oral nucleos(t)ide analogues (NUCs) treatment and clinical outcomes in chronic hepatitis B (CHB) patients.
Aims

We aimed to elucidate whether coexistence of MS and CHB affects the long-term prognosis of CHB patients with oral NUCs treatment.
Methods

We performed a retrospective data analysis for a total of 587 CHB patients who started oral NUCs treatment for the first time in our institution from January 2006 to March 2016.
Results

Among the 587 patients, 70 (11.9%) had MS, but 517 (88.1%) had no evidence of MS when oral NUCs treatment was initiated. Cumulative occurrence rates of viral breakthrough, genotypic resistance, HCC, disease progression (PD), and overall adverse outcomes (OAO) were significantly higher in CHB patients with MS than in those without MS, although HBV-DNA suppression and cumulative occurrence rates of HBeAg negative conversion and seroconversion were not significantly different between the two groups. The overall survival (OS) was also significantly shorter in CHB patients with MS than in those without MS. Multivariate analysis indicated that the MS was an independent, poor prognostic factor for occurrence of genotypic resistance (adjusted hazard ratio [aHR], 22.3; 95% confidence interval [CI] 6.61–75.02; P < 0.001), HCC (aHR, 3.98; 95% CI 2.07–7.66; P < 0.001), PD (aHR, 6.18; 95% CI 3.43–11.14; P < 0.001), OAO (aHR, 8.10; 95% CI 4.68–14.02; P < 0.001), and OS (aHR, 12.29; 95% CI 2.25–67.24; P < 0.001).
Conclusions

MS is an independent determinant of poor prognosis in CHB patients receiving oral NUCs treatment.
Keywords
Metabolic syndrome Nucleos(t)ide analogue Hepatocellular carcinoma Disease progression Survival

StephenW

消化系统疾病与科学

2018年10月，第63卷，第10期，第2792-2799页|引用为
代谢综合征对慢性乙型肝炎患者核苷类似物治疗临床疗效的影响

    作者
    作者和附属机构

    Nam Hee KimYong Kyun ChoByung Ik KimHong Joo KimEmail作者

    Nam Hee Kim
        1
    Yong Kyun Cho
        2
    Byung Ik Kim
        2
    Hong Joo Kim
        2Email authorView作者的OrcID个人资料

    1.预防保健中心，Kangbuk三星医院成都馆大学医学院韩国首尔
    2. Kangbuk三星医院国立大学医学院内科，消化内科，韩国首尔韩国

来源文章
首次在线：2018年6月12日

    109次下载

抽象
背景

没有关于MS对慢性乙型肝炎（CHB）患者的口服核苷（酸）类似物（NUC）治疗和临床结果的影响的数据。
目标

我们的目的是阐明MS和CHB的共存是否会影响口服NUCs治疗的CHB患者的长期预后。
方法

我们对2006年1月至2016年3月在我院首次开始口服NUCs治疗的587名CHB患者进行了回顾性数据分析。
结果

在587名患者中，70名（11.9％）患有MS，但517名（88.1％）在开始口服NUC治疗时没有MS证据。尽管HBV-DNA抑制和HBeAg的累积发生率，但MS患者的病毒突破，基因型耐药，HCC，疾病进展（PD）和总体不良结局（OAO）的累积发生率显着高于无MS患者。负转换和血清转换在两组之间没有显着差异。 MS患者CHB患者的总生存期（OS）也明显短于无MS患者。多变量分析表明MS是基因型耐药性发生的独立预后不良因素（校正风险比[aHR]，22.3; 95％可信区间[CI] 6.61-75.02; P <0.001），HCC（aHR，3.98; 95％CI 2.07-7.66; P <0.001），PD（aHR，6.18; 95％CI 3.43-11.14; P <0.001），OAO（aHR，8.10; 95％CI 4.68-14.02; P <0.001）和OS （aHR，12.29; 95％CI 2.25-67.24; P <0.001）。
结论

MS是接受口服NUC治疗的CHB患者预后不良的独立决定因素。
关键词
代谢综合征核仁（t）ide类似物肝细胞癌疾病进展生存