摘要
目的了解慢性乙型肝炎急性加重患者自然恢复和短期抗病毒干预过程中的乙型肝炎表面抗原定量（HBsAg）动力学变化趋势。方法慢性乙型肝炎急性加重接受恩替卡韦抗HBV治疗的39例患者为A组，未接受任何抗HBV治疗的22例患者为B组，分别在入院时（基线）、极期【终末期肝病模型（MELD）评分分值最高时]、恢复期（出院前）计算MELD评分，并检测HBVDNA载量和HBsAg定量，分别比较两组之间疾病三个时期的MELD评分、HBVDNA载量和HBsAg定量；并且进行同一组内三个时期之间的两两比较。两组问均数比较采用t检验，两组内均数的两两比较采用配对f检验的BONFERRONI法，计数资料（力〈40）采用Fisher精确概率法检验。结果A组入院时、极期、恢复期HBsAg定量分别为（3．68±0．45）log10COI，（3．84±0．19）log10COI和（3．69±0．58）log10COI；B组HBsAg定量分别为（3．59±0．54）tog10C01，（3．47±0．76）log10COI和（3．43±0．68）log10COLA组和B组之间疾病三个时期MELD评分、HBVDNA载量和HBsAg定量比较，除A组HBVDNA极期和恢复期水平低于B组外泸值均〈0．05），其余差异均无统计学意义护值均〉0．05）。抗HBV治疗组中，MELD评分于基线和极期均高于恢复期水平（P=0．000），但基线和极期比较，差异无统计学意义（P=1．000）；HBVDNA载量自基线、极期至恢复期逐渐下降，两两比较，差异均有统计学意义垆值均〈0．05）；HBsAg定量三者之间两两比较，差异均无统计学意义（P值均〉0．05）。非抗HBV治疗组中，MELD评分基线和极期均高于恢复期水平沪=0．000），但基线和极期比较，差异无统计学意义（P=1．000）；HBVDNA载量基线和极期均高于恢复期水平护值分别为0．000和0．003），但基线和极期比较，差异无统计学意义（P：0．619）；HBsAg定量三者之间两两比较；差异均无统计学意义垆值均〉0�
Objective To investigate the dynamic quantitative changes in expression of hepatitis B virus （HBV） surface antigen （HBsAg） that occurs during the natural recovery course and the short- term antivirus treatment period of patients suffering from flares in chronic hepatitis B （CHB）. MethodsCHB patients presenting for treatment of flare-ups were randomly assigned to receive treatment with Enticavir antiviral （group A, n = 39） or to naturally resolve the acute condition （group B, n = 22）. All patients MELD scores were calculated and HBsAg levels and HBV DNA loads were measured upon admission （baseline）, at worst-condition stage, and end of treatment/flare-up （discharge）. Pairwise comparisons of intergroup differences were made to evaluate the change in the three disease parameters over time in response to the management approach. Results The levels of HBsAg were not significantly different between the two groups at baseline, worst-condition stage and discharge （group A： （3.68 ± 0.45）, （3.84 ±0.19） and （3.69 ± 0.58） log10 cut-off index （COD respectively; group B： （3.59 ± 0.54）, （3.47 ±0.76） and （3.43 ±0.68） log10 COI respectively; all P 〉 0.05）. However, the HBV DNA loads were significantly lower in group A than in group B at the worst-condition stage and at discharge （all P 〈 0.05）. In group A, the MELD scores were significantly higher at baseline and at worst-condition stage than at discharge （all P = 0.000）, but the difference between baseline and worst-condition stage was not significant. Also in group A, the HBV DNA load showed a gradually decreasing trend over time （baseline 〉 worst-condition stage 〉 discharge, all P 〈 0.05）. No significant differences were observed over time in the HBsAg levels of group A. In group B, the MELD scores were significantly higher at baseline and at worst-condition stage than at discharge （all P = 0.000）, but the difference between baseline and worst-condition stage was not significant （P
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2013年第8期575-579,共5页
Chinese Journal of Hepatology
基金
基金项目：国家“十二五”科技重大专项“重型乙型肝炎（肝衰竭）临床治疗新方案的研究”（2012ZXLC002004）
关键词
肝炎
乙型
慢性
肝炎表面抗原
病毒载量
Hepatitis B, Chronic
Hepatitis B surface antigens
V＇rral load
