广州医科大学学报
廣州醫科大學學報
엄주의과대학학보
Academic Journal of Guangzhou Medical College
2014年
4期
65-68
,共4页
肝炎,乙型,慢性%肝炎表面抗原,乙型%干扰素α-2b
肝炎,乙型,慢性%肝炎錶麵抗原,乙型%榦擾素α-2b
간염,을형,만성%간염표면항원,을형%간우소α-2b
hepatitis B,chronic%hepatitis B surface antigen%interferon α-2b
目的：探讨HBsAg定量监测对干扰素个体化治疗HBeAg阴性慢性乙型肝炎的指导作用。方法：2010年11月至2013年11月本院就诊的62例HBeAg阴性慢性乙型肝炎患者,采用α-2b干扰素500万IU,皮下注射,隔日1次治疗。抗病毒治疗至24周时根据HBsAg定量下降情况进行分组。 HBsAg定量下降≥1 lg IU/mL的患者纳入A组,HBsAg定量下降<1 lg IU/mL的患者随机分成B1组和B2组。 A组和B1组继续给予α-2b干扰素治疗,B2组加用阿德福韦酯治疗,疗程共48周。所有患者随访24周。结果：A、B1和B2组的持续病毒学应答率分别为88.2％,22.7％和59.1％。 A组和B2组持续病毒学应答率比较,差异无统计学意义,且明显高于B1组。随访24周时A、B1和B2组HBV DNA较基线下降幅度分别为[(5.00±1.62)、(2.70±1.52)和(4.13±2.00)] lg copies/mL, B2组HBV DNA较基线下降幅度与A组接近,明显大于B1组。 A组患者HBsAg平均下降幅度高于B1组和B2组,最终A组有2例(11.8％)HBsAg消失,B1和B2组均为0。结论：HBsAg水平变化与HBeAg阴性慢性乙型肝炎患者抗病毒治疗持续应答相关。干扰素治疗24周时HBsAg下降≥1 lg IU/mL的患者持续病毒学应答率显著高于HBsAg下降<1 lg IU/mL的患者,对干扰素治疗24周时HBsAg下降<1 lg IU/mL患者可联合阿德福韦酯以提高持续病毒学应答率。
目的：探討HBsAg定量鑑測對榦擾素箇體化治療HBeAg陰性慢性乙型肝炎的指導作用。方法：2010年11月至2013年11月本院就診的62例HBeAg陰性慢性乙型肝炎患者,採用α-2b榦擾素500萬IU,皮下註射,隔日1次治療。抗病毒治療至24週時根據HBsAg定量下降情況進行分組。 HBsAg定量下降≥1 lg IU/mL的患者納入A組,HBsAg定量下降<1 lg IU/mL的患者隨機分成B1組和B2組。 A組和B1組繼續給予α-2b榦擾素治療,B2組加用阿德福韋酯治療,療程共48週。所有患者隨訪24週。結果：A、B1和B2組的持續病毒學應答率分彆為88.2％,22.7％和59.1％。 A組和B2組持續病毒學應答率比較,差異無統計學意義,且明顯高于B1組。隨訪24週時A、B1和B2組HBV DNA較基線下降幅度分彆為[(5.00±1.62)、(2.70±1.52)和(4.13±2.00)] lg copies/mL, B2組HBV DNA較基線下降幅度與A組接近,明顯大于B1組。 A組患者HBsAg平均下降幅度高于B1組和B2組,最終A組有2例(11.8％)HBsAg消失,B1和B2組均為0。結論：HBsAg水平變化與HBeAg陰性慢性乙型肝炎患者抗病毒治療持續應答相關。榦擾素治療24週時HBsAg下降≥1 lg IU/mL的患者持續病毒學應答率顯著高于HBsAg下降<1 lg IU/mL的患者,對榦擾素治療24週時HBsAg下降<1 lg IU/mL患者可聯閤阿德福韋酯以提高持續病毒學應答率。
목적：탐토HBsAg정량감측대간우소개체화치료HBeAg음성만성을형간염적지도작용。방법：2010년11월지2013년11월본원취진적62례HBeAg음성만성을형간염환자,채용α-2b간우소500만IU,피하주사,격일1차치료。항병독치료지24주시근거HBsAg정량하강정황진행분조。 HBsAg정량하강≥1 lg IU/mL적환자납입A조,HBsAg정량하강<1 lg IU/mL적환자수궤분성B1조화B2조。 A조화B1조계속급여α-2b간우소치료,B2조가용아덕복위지치료,료정공48주。소유환자수방24주。결과：A、B1화B2조적지속병독학응답솔분별위88.2％,22.7％화59.1％。 A조화B2조지속병독학응답솔비교,차이무통계학의의,차명현고우B1조。수방24주시A、B1화B2조HBV DNA교기선하강폭도분별위[(5.00±1.62)、(2.70±1.52)화(4.13±2.00)] lg copies/mL, B2조HBV DNA교기선하강폭도여A조접근,명현대우B1조。 A조환자HBsAg평균하강폭도고우B1조화B2조,최종A조유2례(11.8％)HBsAg소실,B1화B2조균위0。결론：HBsAg수평변화여HBeAg음성만성을형간염환자항병독치료지속응답상관。간우소치료24주시HBsAg하강≥1 lg IU/mL적환자지속병독학응답솔현저고우HBsAg하강<1 lg IU/mL적환자,대간우소치료24주시HBsAg하강<1 lg IU/mL환자가연합아덕복위지이제고지속병독학응답솔。
Objective:To explore the directive value of serum HBsAg quantification for individualized interferon treatment in patients with HBeAg-negative chronic hepatitis B. Methods: 62 patients with HBeAg-negative CHB admitted in our hospital from November 2010 to November 2013 were given IFNα-2b 5MIU, and injected subcutaneously every other day. Till the 24 th week of antiviral therapy, they were divided into groups basing on the decrease condition of HBsAg quantification. Then, patients showing a decrease of serum HBsAg level ≥1lg IU/mL were included into group A. Other patients showing a decrease of serum HBsAg level<1lg IU/mL were divided into B1 and B2 groups randomLy. Patients in group A and B1 went on being treated by IFNα-2b. Patients in group B2 were given adefovir dipivoxil on the basic treatment. And the course of treatment was 48 weeks. All subjects were followed up for 24 weeks. Results: Rates of sustained virological response ( SVR) for groups A, B1 and B2 were 88.2%,22.7% and 59.1% respectively. SVR rate for group B1 was the lowest, and there was no significant difference between group A and B2. On the 24th week of follow-up, HBV DNA decline levels of groups A, B1 and B2 were 5.00±1.62, 2.70±1.52 and 4.13±2.00 lg copies/mL respectively. HBV DNA decline level of group B2 was close to group A, and was greater than group B1. The mean decline in serum HBsAg level of group A was greater than group B1 and group B2. HBsAg of 2 cases (11.8%) lost in group A, while none of patents in group B1 or B2 got HBsAg loss.Conclusion:The change in serum HBsAg level is related to continuous response of the antiviral therapy in patients with HBeAg-negative chronic hepatitis B. SVR rates of those patients showing a decrease of serum HBsAg level≥1lg IU/mL in week 24 will be higher than the patients showing a decrease of serum HBsAg level<1lg IU/mL. If patients show a decrease of serum HBsAg level<1lg IU/mL in week 24 of interferon treatment, combining with adefovir dipivoxil is suggested to increase SVR rate.
