中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2012年
10期
598-602
,共5页
俎燕会%刘志荣%董格峰%王昌源%孙玉秋%陈士俊
俎燕會%劉誌榮%董格峰%王昌源%孫玉鞦%陳士俊
조연회%류지영%동격봉%왕창원%손옥추%진사준
肝炎,乙型,慢性%肝炎e抗原,乙型%鸟嘌呤%DNA,病毒%肝炎病毒,乙型
肝炎,乙型,慢性%肝炎e抗原,乙型%鳥嘌呤%DNA,病毒%肝炎病毒,乙型
간염,을형,만성%간염e항원,을형%조표령%DNA,병독%간염병독,을형
Hepatitis B,chronic%Hepatitis B e antigen%Guanine: DNA,viral%Hepatitis B virus
目的 了解慢性乙型肝炎患者HBeAg水平与恩替卡韦长期治疗效果的关系.方法 根据治疗前HBeAg水平,将59例慢性乙型肝炎患者分为3组:A组19例,HBeAg≥1000 s/co;B组20例,HBeAg为100～999 s/co;C组20例,HBeAg＜ 100 s/co.回顾性分析接受恩替卡韦治疗前HBeAg水平、治疗24周后HBeAg变化及其与144周疗效的关系.应用x2检验进行数据分析.结果 3组患者治疗前年龄、ALT水平的差异无统计学意义,而HBV DNA水平与HBeAg水平相关.59例患者治疗144周时ALT复常者58例(98.3％),HBV DNA水平达到检测限以下者56例(94.9％),HBeAg转阴30例(50.8％),HBeAg血清学转换26例(44.1％).3组患者ALT复常及HBV DNA转阴率的差异无统计学意义(x2=2.4146,P=0.3427;x2=2.2375,P=0.3267),而HBeAg转阴及血清学转换率的差异有统计学意义(x2=7.6484,P=0.0218;x2=7.6455,P=0.0219).C组患者治疗144周时HBeAg转阴率为70.0％,血清学转换率为65.0％,高于B组的55.0％和45.0％,以及A组的26.3％和21.0％.治疗24周时HBeAg 下降＞1 lg s/co的33例患者,144周时HBeAg血清学转换高达22例(66.7％),而其他26例患者仅有4例(15.4％)出现HBeAg血清学转换(P＜0.01).实现HBeAg血清学转换的26例患者中已经有20例停药,其中3例HBsAg清除.结论 HBeAg阳性慢性乙型肝炎患者治疗前HBeAg的水平,特别是治疗24周时HBeAg下降＞1 lg s/co者,对于恩替卡韦治疗144周的疗效,特别是HBeAg血清转换率具有重要的预测价值.
目的 瞭解慢性乙型肝炎患者HBeAg水平與恩替卡韋長期治療效果的關繫.方法 根據治療前HBeAg水平,將59例慢性乙型肝炎患者分為3組:A組19例,HBeAg≥1000 s/co;B組20例,HBeAg為100～999 s/co;C組20例,HBeAg＜ 100 s/co.迴顧性分析接受恩替卡韋治療前HBeAg水平、治療24週後HBeAg變化及其與144週療效的關繫.應用x2檢驗進行數據分析.結果 3組患者治療前年齡、ALT水平的差異無統計學意義,而HBV DNA水平與HBeAg水平相關.59例患者治療144週時ALT複常者58例(98.3％),HBV DNA水平達到檢測限以下者56例(94.9％),HBeAg轉陰30例(50.8％),HBeAg血清學轉換26例(44.1％).3組患者ALT複常及HBV DNA轉陰率的差異無統計學意義(x2=2.4146,P=0.3427;x2=2.2375,P=0.3267),而HBeAg轉陰及血清學轉換率的差異有統計學意義(x2=7.6484,P=0.0218;x2=7.6455,P=0.0219).C組患者治療144週時HBeAg轉陰率為70.0％,血清學轉換率為65.0％,高于B組的55.0％和45.0％,以及A組的26.3％和21.0％.治療24週時HBeAg 下降＞1 lg s/co的33例患者,144週時HBeAg血清學轉換高達22例(66.7％),而其他26例患者僅有4例(15.4％)齣現HBeAg血清學轉換(P＜0.01).實現HBeAg血清學轉換的26例患者中已經有20例停藥,其中3例HBsAg清除.結論 HBeAg暘性慢性乙型肝炎患者治療前HBeAg的水平,特彆是治療24週時HBeAg下降＞1 lg s/co者,對于恩替卡韋治療144週的療效,特彆是HBeAg血清轉換率具有重要的預測價值.
목적 료해만성을형간염환자HBeAg수평여은체잡위장기치료효과적관계.방법 근거치료전HBeAg수평,장59례만성을형간염환자분위3조:A조19례,HBeAg≥1000 s/co;B조20례,HBeAg위100～999 s/co;C조20례,HBeAg＜ 100 s/co.회고성분석접수은체잡위치료전HBeAg수평、치료24주후HBeAg변화급기여144주료효적관계.응용x2검험진행수거분석.결과 3조환자치료전년령、ALT수평적차이무통계학의의,이HBV DNA수평여HBeAg수평상관.59례환자치료144주시ALT복상자58례(98.3％),HBV DNA수평체도검측한이하자56례(94.9％),HBeAg전음30례(50.8％),HBeAg혈청학전환26례(44.1％).3조환자ALT복상급HBV DNA전음솔적차이무통계학의의(x2=2.4146,P=0.3427;x2=2.2375,P=0.3267),이HBeAg전음급혈청학전환솔적차이유통계학의의(x2=7.6484,P=0.0218;x2=7.6455,P=0.0219).C조환자치료144주시HBeAg전음솔위70.0％,혈청학전환솔위65.0％,고우B조적55.0％화45.0％,이급A조적26.3％화21.0％.치료24주시HBeAg 하강＞1 lg s/co적33례환자,144주시HBeAg혈청학전환고체22례(66.7％),이기타26례환자부유4례(15.4％)출현HBeAg혈청학전환(P＜0.01).실현HBeAg혈청학전환적26례환자중이경유20례정약,기중3례HBsAg청제.결론 HBeAg양성만성을형간염환자치료전HBeAg적수평,특별시치료24주시HBeAg하강＞1 lg s/co자,대우은체잡위치료144주적료효,특별시HBeAg혈청전환솔구유중요적예측개치.
Objective To study the correlation between HBeAg levels and the efficacy of entecavir long-term treatment in chronic hepatitis B (CHB) patients.Methods Fifty-nine HBeAgpositive CHB patients were divided into three groups according to baseline HBeAg levels:Group A (n=19,HBeAg≥1000 s/co),Group B (n=20,HBeAg 100 999 s/co) and Group C (n=20,HBeAg＜ 100 s/co).The HBeAg level at baseline and week 24 of entecavir treatment were retrospectively analyzed,and the correlation between changes of HBeAg level and efficacy of 144-week entecavir treatment was also analyzed.Data were analyzed by x2 test.Results There were no statistical differences of age and baseline alanine transaminase (ALT) levels among 3 groups,but hepatitis B virus (HBV) DNA level was correlated with HBeAg level.After 144 weeks of entecavir treatment,58 patients (58/59,98.3％) achieved ALT normahzation,56 (56/59,94.9％) achieved HBV DNA undetectable,30 (30/59,50.8％) achieved HBeAg loss,and 26 (26/59,44.1％)achieved HBeAg seroconversion.There were no statistical differences of ALT normalization rate and HBV DNA undetectable rate among three groups (x2 =2.4146,P=0.3427; x2 =2.2375,P=0.3267,respectively),while there were statistical differences of HBeAg loss rate and HBeAg seroconversion rate among three groups (x2=7.6484,P =0.0218; x2 =7.6455,P =0.0219,respectively).The HBeAg loss and HBeAg seroconversion rates in group C were 70.0％ and 65.0％,respectively,which were both higher than group B (55.0％ and 45.0％,respectively) and group A (26.3 ％ and 21.0 ％,respectively).Among 33 patients whose HBeAg levels declined ＞1 lg s/co after 24-week treatment,22 (66.7％) achieved HBeAg seroconversion after 144-week treatment,while only 4 (4/26,15.4％) achieved HBeAg seroconversion in other 26 patients (P＜0.01).Among 26 patients who achieved HBeAg seroconversion,20 had withdrawn entecavir therapy and 3 achieved HBsAg sero-clearanee.Conclusion In HBeAg positive CHB patients,the baseline HBeAg level,especially HBeAg level declining＞1 lg s/co after 24-week treatment have good predictive value for the 144 week efficacy of entecavir treatment,especially for HBeAg seroconversion.
