空气污染阻碍了使用核酸/核酸类似物治疗的慢性乙型肝炎患者的ALT正常化
Tyng-Yuan Jang1,2,3, Chi-Chang Ho4, Chih-Da Wu5,6
1Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung, Taiwan.
Medicine
|October 31, 2023
概括
核酸/核酸模拟疗法改善了慢性乙型肝炎 (CHB) 患者的阿氨酸转移酶 (ALT) 正常化. 然而,空气污染,特别是臭氧,独立地影响ALT正常化成功.
科学领域:
- 肝病学和病毒性胃肠道学
- 环境健康和毒理学
- 生物化学和临床诊断学
背景情况:
- 氨酸氨基转移酶 (ALT) 的正常化是接受核酸/核酸模拟剂 (NA) 治疗的慢性乙型肝炎 (CHB) 患者的关键预后指标.
- 环境空气污染物对CHB患者ALT正常化的影响仍然在很大程度上未被探索.
研究的目的:
- 研究空气污染对接受NA治疗的B型肝炎e抗原阴性CHB患者ALT正常化的影响.
- 为了确定与ALT异常相关的风险因素,尽管NA治疗.
主要方法:
- 一项纵向研究涉及80名B型肝炎e抗原阴性CHB患者,接受NAs治疗.
- 在基线和治疗1年后测量ALT水平.
- 与空气污染物的汇总月度数据进行相关性分析,包括PM2.5,二氧化,臭氧 (O3) 和.
主要成果:
- 在NA治疗1年后,93.8%的患者达到无法检测的乙型肝炎病毒DNA水平,平均ALT水平显著降低 (30.0至21.3U/L).
- 患有正常ALT水平的患者比例显著增加,从51.2%增加到71.2%.
- 较高的体重指数 (OR,1.28) 和增加的臭氧水平 (OR,1.11) 独立地与治疗1年后异常的ALT水平相关.
结论:
- 一年NA治疗有效改善ALT水平,并增加低病毒载荷的CHB患者的正常化率.
- 空气污染,特别是臭氧,构成了重大环境挑战,影响了CHB患者ALT正常化疗法的有效性.
- 增加的BMI和暴露于臭氧是管理CHB患者ALT正常化时需要考虑的关键因素.
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