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非酒精性脂肪肝如何影响 e 抗原阳性慢性乙型肝炎患者抗病 [复制链接]

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发表于 2022-10-14 20:19 |只看该作者 |倒序浏览 |打印
非酒精性脂肪肝如何影响 e 抗原阳性慢性乙型肝炎患者抗病毒治疗的荟萃分析
陈延东 1 , 刘强 1 , 景涵 1 , 高思雨 1 , 钱晓 1 , 黄晓丽 1 , 陆路 1 , 周晓琳 1
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    【作者单位】: 中国三峡大学第一临床医学院宜昌市中心人民医院;

    PMID:36225715 PMCID:PMC9550465 DOI:10.1155/2022/4774195

抽象的

背景:非酒精性脂肪性肝病(NAFLD)和慢性乙型肝炎(CHB)都是导致肝硬化和肝细胞癌的最常见的基础疾病,NAFLD和HBV感染是中国慢性肝病的第一和第二大病因。然而,关于CHB和NAFLD的联合存在是否会与HBV一起影响肝病的病程或结果,以及两者如何相互影响,仍然存在很多争议。

目的:探讨非酒精性脂肪肝(NAFLD)对慢性乙型肝炎(CHB)患者抗病毒治疗的影响。

方法:计算机检索PubMed、CNKI、唯品会、万方数据知识服务平台等数据库。时间范围是从数据库创建到 2022 年 6 月。搜索主题词是乙型肝炎、慢性乙型肝炎或 NAFLD。观察组为e抗原阳性CHB合并NAFLD患者,对照组为e抗原+CHB患者。包括标题、名称、出版日期、样本数量、抗病毒药物和结果指标在内的提取物用于 Meta 分析。绘制漏斗​​图以分析文献偏差。

结果:最终纳入 7 篇论文,共 1348 例 HBeAg + CHB 患者(观察组:n = 547,对照组:n = 801)。

结果:最终纳入 7 篇论文,共 1348 例 HBeAg + CHB 患者(观察组:n = 547,对照组:n = 801)。结果。 Meta 分析显示,以 HBV DNA 转化率、ALT 正常化和 HBeAg 转化率三个结果指标衡量,NAFLD 的 CHB 患者在接受核苷酸类似物抗病毒治疗 48 周后的疗效低于 CHB 患者。

结应给予合理的抗病毒治疗。

版权所有 © 2022 陈延东等。
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作者声明,本文的发表不存在利益冲突。

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发表于 2022-10-14 20:20 |只看该作者
A Meta-Analysis of How Nonalcoholic Fatty Liver Disease Affect Antiviral Treatment of Patients with e Antigen-Positive Chronic Hepatitis B
Yandong Chen  1 , Qiang Liu  1 , Jing Han  1 , Siyu Gao  1 , Qian Xiao  1 , Xiaoli Huang  1 , Lu Lu  1 , Xiaolin Zhou  1
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    1
    Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, China.

    PMID: 36225715 PMCID: PMC9550465 DOI: 10.1155/2022/4774195

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis B (CHB) are both the most common underlying diseases leading to cirrhosis and hepatocellular carcinoma, and NAFLD and HBV infection are the first and second leading causes of chronic liver disease in China. However, there are still a lot of controversies about whether the combined presence of CHB and NAFLD will affect the course or outcome of liver disease together with HBV, and how the two affect each other.

Objective: To investigate the effect of nonalcoholic fatty liver disease (NAFLD) on antiviral therapy in patients with chronic hepatitis B (CHB).

Methods: Computer searches of databases such as PubMed, CNKI, VIP.com, and Wanfang Data Knowledge Service Platform were used. The time frame was from the creation of the database to June 2022. The search subject terms were hepatitis B, CHB, or NAFLD. The observation group consisted of patients with e antigen-positive CHB with NAFLD, and the control group consisted of patients with e-antigen + CHB. Extracts including title, name, date of publication, number of samples, antiviral drugs, and outcome indicators were used for Meta-analysis. Funnel plots were drawn to analyze literature bias.

Results: Seven papers including 1348 patients with HBeAg + CHB (observation group: n = 547, control group: n = 801) were finally included.

Results: Seven papers including 1348 patients with HBeAg + CHB (observation group: n = 547, control group: n = 801) were finally included. Results. Meta-analysis showed that CHB patients with NAFLD had lower efficacy than CHB patients after 48 weeks of antiviral treatment with nucleotide analogs, as measured by three outcome indicators HBV DNA conversion rate, ALT-normalization, and HBeAg conversion rate.

Conclusion: NAFLD reduces the effect of antiviral therapy in CHB patients, and the clinicopathological features of patients with NAFLD combined with chronic hepatitis B are different from those of patients with chronic hepatitis B alone, so early diagnosis by liver histological examination should be actively performed and reasonable antiviral therapy should be administered.

Copyright © 2022 Yandong Chen et al.
Conflict of interest statement

The authors declare that there are no conflicts of interest regarding the publication of this paper.

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发表于 2022-10-14 20:20 |只看该作者
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