CAJ | 학술논문

目的探讨血清cccDNA在阿德福韦酯治疗慢性乙型肝炎(CHB)中的临床意义. 方法选取81例CHB确诊患者,对所有病例的血清cccDNA进行检测,根据检测结果分为cccDNA阳性组和cccDNA阴性组,所有患者给予阿德福韦酯治疗口服(10mg/d),每24周随访一次,连续随访4次,治疗前及随访时检测HBV DNA、HBeAg及ALT等指标. 结果 cccDNA阳性与阴性两组患者的年龄及性别比较,差异无统计学意义(P＞0.05).两组在接受阿德福韦酯治疗的过程中,HBV DNA的中位数随着治疗时间的延长而下降,阴性组下降较阳性组明显.HBeAg变化,24周时两组与各自基线及两组之间比较差异无统计学意义(P＞0.05),于48、72及96周,两组HBeAg与各自基线及两组之间比较差异有统计学意义(P＜0.05);ALT变化,两组间在基线、24和48周时比较差异无统计学意义(P＞0.05),72及96周比较差异有统计学意义(P＜0.05). 结论随着阿德福韦酯治疗时间的延长,cccDNA阴性组的HBV DNA载量、HBeAg滴度及ALT下降较阳性组快,即阴性组应答高于阳性组,因而说明血清cccDNA能够预测阿德福韦酯的远期疗效.
목적 탐토혈청cccDNA재아덕복위지치료만성을형간염(CHB)중적림상의의. 방법 선취81례CHB학진환자,대소유병례적혈청cccDNA진행검측,근거검측결과분위cccDNA양성조화cccDNA음성조,소유환자급여아덕복위지치료구복(10mg/d),매24주수방일차,련속수방4차,치료전급수방시검측HBV DNA、HBeAg급ALT등지표. 결과 cccDNA양성여음성량조환자적년령급성별비교,차이무통계학의의(P＞0.05).량조재접수아덕복위지치료적과정중,HBV DNA적중위수수착치료시간적연장이하강,음성조하강교양성조명현.HBeAg변화,24주시량조여각자기선급량조지간비교차이무통계학의의(P＞0.05),우48、72급96주,량조HBeAg여각자기선급량조지간비교차이유통계학의의(P＜0.05);ALT변화,량조간재기선、24화48주시비교차이무통계학의의(P＞0.05),72급96주비교차이유통계학의의(P＜0.05). 결론 수착아덕복위지치료시간적연장,cccDNA음성조적HBV DNA재량、HBeAg적도급ALT하강교양성조쾌,즉음성조응답고우양성조,인이설명혈청cccDNA능구예측아덕복위지적원기료효.
Objective To investigate the clinical value of serum cccDNA in treatment of chronic hepatitis B (CHB)by adefovir dipivoxil(ADV). Methods 81 patients with CHB were selected and detected for serum cccDNA. All the patients received ADV treatment( 10 mg/d)and were followed-up once every 24 weeks, for four times. They were divided into two groups(positive and negative groups)by detecting serum cccDNA. HBV DNA, HBeAg, and ALT were detected before and after ADV treatment at week 24, 48, 72 and 96. Results There were no significant differences in age and sexual distiction between two groups of cccDNA positive and negative ( P ＞ 0. 05). The median of HBV DNA decreased gradually with the time of treatment, especially in cccDNA negative group. There was significant difference in the decrease of HBeAg at week 48,72,96( P ＜ 0.05), except the time of baseline and week 24( P ＞ 0.05). There was no significant difference in the decrease of ALT at baseline and week 24,48( P ＞ 0.05), except week 72,96( P ＜ 0.05).Conclusions Withprolonging treatment,HBV DNA, HBeAg and ALT decrease faster in cccDNA negative group than in positive group, so serum cccDNA can be seen as a predictive mark when chronic hepatitis B treated by ADV.