中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
2009年
6期
330-333,348
,共5页
高海兵%潘晨%林明华%周锐%郑玲%林太杰%许利军%原津津%方建凯
高海兵%潘晨%林明華%週銳%鄭玲%林太傑%許利軍%原津津%方建凱
고해병%반신%림명화%주예%정령%림태걸%허리군%원진진%방건개
肝炎%乙型%慢性%肝炎e抗原%乙型%肿瘤坏死因子α%阿德福韦酯
肝炎%乙型%慢性%肝炎e抗原%乙型%腫瘤壞死因子α%阿德福韋酯
간염%을형%만성%간염e항원%을형%종류배사인자α%아덕복위지
Chronic hepatitis B%Hepatitis B e antigens%Tumor necrosis factor-alpha%Adefovir dipivoxil
目的 探讨基线血清TNFα、ALT、HBV DNA载量及24周HBV血清学标志物等因素对阿德福韦酯(ADV)治疗HBeAg阳性慢性乙型肝炎(CHB)48周时患者血清学应答的预测价值.方法 203例HBeAg阳性CHB患者口服ADV治疗48周,10 mg/d.采用ELISA测定HBV血清学标志物和基线血清TNFα水平,荧光定量PCR检测HBV DNA,Logistic回归分析影响HBeAg阳性患者血清学应答的因素.结果 203例患者治疗24周时HBV DNA转阴率为31.5%(64/203),ALT复常率为59.1%(120/203),HBeAg转阴率为15.8%(32/203),HBeAg转换率为8.9%(18/203),应答率为13.3%(27/203);治疗48周时HBV DNA转阴率为58.6%(119/203),ALT复常率为78.3%(159/203),HBeAg转阴率29.6%为(60/203),HBeAg转换率为16.7%(34/203),应答率为25.6%(52/203).Logistic回归分析发现,48周HBeAg转阴的患者较未转阴者的24周HBV DNA转阴率、HBeAg转阴率及转换率、基线TNFa水平高(P值分别为0.017、0.001、0.029和0.040);48周HBeAg转换的患者较未转换者的24周HBeAg转换率高,而基线HBV DNA低(P值分别为0.000和0.004).结论 24周HBV DNA转阴率、HBeAg转阴率和转换率,及基线TNFα水平可以预测48周HBeAg转阴率,而24周HBeAg转换率和基线HBV DNA载量可以预测48周HBeAg转换率.
目的 探討基線血清TNFα、ALT、HBV DNA載量及24週HBV血清學標誌物等因素對阿德福韋酯(ADV)治療HBeAg暘性慢性乙型肝炎(CHB)48週時患者血清學應答的預測價值.方法 203例HBeAg暘性CHB患者口服ADV治療48週,10 mg/d.採用ELISA測定HBV血清學標誌物和基線血清TNFα水平,熒光定量PCR檢測HBV DNA,Logistic迴歸分析影響HBeAg暘性患者血清學應答的因素.結果 203例患者治療24週時HBV DNA轉陰率為31.5%(64/203),ALT複常率為59.1%(120/203),HBeAg轉陰率為15.8%(32/203),HBeAg轉換率為8.9%(18/203),應答率為13.3%(27/203);治療48週時HBV DNA轉陰率為58.6%(119/203),ALT複常率為78.3%(159/203),HBeAg轉陰率29.6%為(60/203),HBeAg轉換率為16.7%(34/203),應答率為25.6%(52/203).Logistic迴歸分析髮現,48週HBeAg轉陰的患者較未轉陰者的24週HBV DNA轉陰率、HBeAg轉陰率及轉換率、基線TNFa水平高(P值分彆為0.017、0.001、0.029和0.040);48週HBeAg轉換的患者較未轉換者的24週HBeAg轉換率高,而基線HBV DNA低(P值分彆為0.000和0.004).結論 24週HBV DNA轉陰率、HBeAg轉陰率和轉換率,及基線TNFα水平可以預測48週HBeAg轉陰率,而24週HBeAg轉換率和基線HBV DNA載量可以預測48週HBeAg轉換率.
목적 탐토기선혈청TNFα、ALT、HBV DNA재량급24주HBV혈청학표지물등인소대아덕복위지(ADV)치료HBeAg양성만성을형간염(CHB)48주시환자혈청학응답적예측개치.방법 203례HBeAg양성CHB환자구복ADV치료48주,10 mg/d.채용ELISA측정HBV혈청학표지물화기선혈청TNFα수평,형광정량PCR검측HBV DNA,Logistic회귀분석영향HBeAg양성환자혈청학응답적인소.결과 203례환자치료24주시HBV DNA전음솔위31.5%(64/203),ALT복상솔위59.1%(120/203),HBeAg전음솔위15.8%(32/203),HBeAg전환솔위8.9%(18/203),응답솔위13.3%(27/203);치료48주시HBV DNA전음솔위58.6%(119/203),ALT복상솔위78.3%(159/203),HBeAg전음솔29.6%위(60/203),HBeAg전환솔위16.7%(34/203),응답솔위25.6%(52/203).Logistic회귀분석발현,48주HBeAg전음적환자교미전음자적24주HBV DNA전음솔、HBeAg전음솔급전환솔、기선TNFa수평고(P치분별위0.017、0.001、0.029화0.040);48주HBeAg전환적환자교미전환자적24주HBeAg전환솔고,이기선HBV DNA저(P치분별위0.000화0.004).결론 24주HBV DNA전음솔、HBeAg전음솔화전환솔,급기선TNFα수평가이예측48주HBeAg전음솔,이24주HBeAg전환솔화기선HBV DNA재량가이예측48주HBeAg전환솔.
Objective To investigate the predictive value of TNFα,ALT,HBV DNA loads and HBV serological markers in response to adefovir dipivoxil (ADV) treatment for patients with chronic hepatitis B(CHB).Methods Two hundred and three HBeAg.positive CHB patients were administered with ADV 10 mg/d for 48 weeks.HBV serological markers and TNFα at the baseline were determined by enzyme linked immunosorbent assay(EUSA),and HBV DNA loads were detected by PCR.Logistic regression was used to identify predictive factors for serological response at 48th week after the treatment.Results The rates of HBV DNA clearance,ALT normalization,HBeAg lOSS,HBeAg seroconversion and response at 24th week were 31.5%(64/203),59.1%(120/203),15.8%(32/203).8.9%(18/203)and 13.3%(27/203)respectively,while those at 48th week were 58.6%(119/203),78.3%(159/203),29.6%(60/203),16.7%(34/203)and 25.6%(52/203),respectively.Patients who achieved HBeAS loss at 48th week were found to have higher rates of HBV DNA clearance.HBeAg loss and seroconversion at 24th week and higher TNFα at baseline(P=0.017,0.ooI,0.029 and 0.040),while those who achieved HBeAg seroconversion at 48th week were found to have higher rate of HBeAg seroconversion at 24th week.and lower baseline HBV DNA loads(P=0.000 and 0.004).Conclusion For HBeAg.positive CHBpatients with ADV treatment,the rate of HBV DNA clearanee,HBeAg loss and seroeonversion at 24th week and TNFα at baseline may be used to predict the rate of HBeAg 1088 at 48th week:the rate of HBeAgseroconversion at 24th week and baseline HBV DNA loads may be used to predict the rate of HBeAgseroeonversion at 48th week.
