索磷布韦/达拉他韦治疗的慢性丙型肝炎患者血尿酸水平变化研究*

doi:10.3969/j.issn.1672-5069.2024.01.008

摘要/Abstract

摘要： 目的分析索磷布韦/达拉他韦治疗的慢性丙型肝炎(CHC)患者血尿酸(SUA)水平变化及其对疗效的影响。方法 2018年6月～2023年6月我院收治的CHC患者200例,治疗前存在高SUA血症者38例,均接受索磷布韦/达拉他韦治疗24周,随访24周。结果高SUA组和正常SUA组CHC患者体质指数(BMI)为(26.9±3.5)kg/m²和(24.2±2.5)kg/m²,差异有统计学意义(P<0.05),高SUA组血清TG和肝脏脂肪受控衰减参数(CAP)分别为(2.8±0.5)mmol/L和(273.5±15.3)dB/m,显著高于正常SUA组【分别为(1.9±0.6)mmol/L和(236.8±16.1)dB/m,P<0.05】; 高SUA组快速病毒学应答 (RVR)率和早期病毒学应答(EVR)率分别为78.9%和84.2%,显著低于正常SUA组(分别为96.9%和100.0%,P<0.05),而两组治疗结束病毒学应答(ETVR)率和持续病毒学应答(SVR)率无显著性差异(分别为94.7%对100.0%,和97.4%对100.0%,P>0.05);治疗结束时,16例男性和22例女性高SUA患者血SUA水平均趋于下降,下降比例分别占93.7%和72.7%。结论伴有高SUA血症的CHC患者可能影响直接抗病毒药物治疗的早期病毒学应答,但基本不影响SVR,且治疗后大多数患者血SUA水平会降至正常。

关键词: 慢性丙型肝炎, 索磷布韦, 达拉他韦, 高尿酸血症, 治疗

Abstract: Objective The purpose of this study was to investigate the impact of hyperuricemia on virological response to sofosbuvir/daratavir therapy in patients with chronic hepatitis C (CHC). Methods 200 patients with CHC, including 38 patients with hyperuricemia, were recruited in our hospital between June 2018 and June 2023, and all received sofosbuvir/daratavir therapy for 24 weeks. The patients with CHC were followed-up for 24 weeks after discontinuation of the antiviral treatment. Results The body mass index, serum triglyceride level and the controlled attenuation parameter of liver in patients with hyperuricemia were (26.9±3.5)kg/m², (2.8±0.5)mmol/L and (273.5±15.3)dB/m, all significantly higher than (24.2±2.5)kg/m²,(1.9±0.6)mmol/L and (236.8±16.1)dB/m, respectively, P<0.05] in 162 patients with normal serum uric acid levels; the rapid virological response (RVR) and early virological response (EVR) in patients with hyperuricemia were 78.9% and 84.2%, both significantly lower than 96.9% and 100.0% (P<0.05) in patients with normal serum uric acid levels, while there were no significant differences as respect to the end of treatment virological response (94.7% vs. 100.0%) and the sustained virological response (97.4% vsl 100.0% (P>0.05) between the two groups; generally, serum uric acid levels in 16 male and 22 female patients with hyperuricemia at presentation decreased at the end of antiviral treatment, and the percentages of patients with decreased serum uric acid levels was 93.7% in male and 72.7% in female patients. Conclusion The hyperuricemia in patients with CHC might interfere with the early virological response to direct acting agent therapy, but do not impact the sustained virological response, and serum uric acid levels in most patients with hyperuricemia will return to normal.

Key words: Hepatitis C, Sofosbuvir, Daratavir, Hyperuricemia, Therapy

唐智权, 杨婷, 李开铃. 索磷布韦/达拉他韦治疗的慢性丙型肝炎患者血尿酸水平变化研究^*[J]. 实用肝脏病杂志, 2024, 27(1): 28-31.

Tang Zhiquan, Yang Ting, Li Kailing. Impact of hyperuricemia on virological response to sofosbuvir/daratavir therapy in patients with chronic hepatitis C[J]. Journal of Practical Hepatology, 2024, 27(1): 28-31.

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索磷布韦/达拉他韦治疗的慢性丙型肝炎患者血尿酸水平变化研究^*

Impact of hyperuricemia on virological response to sofosbuvir/daratavir therapy in patients with chronic hepatitis C

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