摘要
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≥1000s／co；B组20例，HBeAg为100～999s／co；C组20例，HBeAg〈100s／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HBVDNA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％），HBVDNA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HBVDNA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〉1lgs／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〈O．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〉11gs／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。
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 HBeAg- positive 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 Z2 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 normalization, 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 HBVDNA 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 （Z2= 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 〉 11g s/co after 24-week treatment, 22 （66. 7%） achieved HBeAg seroconversion after 144-week treatment, while only 4 （4/26, 15.4G） 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-elearance. Conclusion In HBeAg
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2012年第10期598-602,共5页
Chinese Journal of Infectious Diseases
