摘要
目的评价初治、单药使用替比夫定治疗HBeAg阳性的慢性乙型肝炎(CHB)患者48周的e抗原血清学转换的基线预测因素。方法 97例HBeAg阳性CHB患者分别以基线HBsAg、ALT和HBVDNA水平高低分组,对比两组治疗48周时生化学、病毒学和血清学应答情况。结果基线HBsAg≤1 500 IU/mL组e抗原阴转率和血清学转换率均为42.3%,基线HBsAg>1 500 IU/mL组分别为20%和17.8%,两组比较差异均有统计学意义(P<0.05);基线ALT>5 ULN组e抗原阴转率和血清学转换率均为45.1%,基线ALT≤5 ULN组分别17.4%和15.2%,两组比较差异均有统计学意义(P<0.01);基线HBVDNA<8.0log10copies/mL组和基线HBVDNA≥8.0 log10copies/mL组e抗原阴转率和血清学转换率相比,差异无统计学意义(P>0.05);基线水平HBsAg≤1 500 IU/mL且ALT>5 ULN的CHB患者共40例作为观察组,其余57例患者作为对照组,治疗48周时观察组e抗原阴转率和血清学转换率均为45%,对照组分别为22.8%和21.1%,两组比较差异均有统计学意义(P<0.05)。结论基线HBsAg水平≤1 500 IU/mL和ALT水平>5 ULN的HBeAg阳性慢性乙型肝炎患者,在接受替比夫定治疗48周时,有较高的e抗原转阴率和血清学转换率;基线HBsAg和ALT水平是替比夫定治疗e抗原血清学转换的重要预测因素。
Objective To evaluate the baseline forecasting factor of HBeAg seroconversion withtelbivudine （LDT） monotherapy in treatment-naive HBeAg-positive chronic hepatitis B （CHB） patients for 48 weeks. Methods Ninety-seven HBeAg-positive CHB patients were divided into two group according to the baseline levels of HBsAg, ALT and HBVDNA; and the biochemical, virological, serological profiles at Week 48 were compared between the two groups. Results The group with baseline levels of HBsAg ≤ 1500 IU/mL showed higher rates of HBeAg nega- tive （42.3% vs 20% ; P 〈 0.05） and HBeAg seroconversion （42.3% vs 17.8% ; P 〈 0.05） ; the group with baseline levels of ALT 〉5 ULN showed higher rates of HBeAg negative （45. 1% vs 17.4% ; P 〈0. O1） and HBeAg seroeonversion （45.1% vs 15.2% ; P 〈0.01 ）. Comparison between the group with baseline levels of HB-VDNA ≤ 7.9 logl0 copies/mL and the group with HBVDNA ≥ 8.0 lOgl0 copies/mL showed no significant differ- ence in the rates of HBeAg negative and seroconversion （ P 〉 0.05 ） ; the group with baseline levels of HBsAg ≤ 1 500 IU/mL and ALT 〉 5 ULN showed higher rates of HBeAg negative （45% vs 22. 8% ; P 〈 0.05 ） and HBeAg seroconversion （45% vs 21.1% ; P 〈 0.05 ）. Conclusion CHB patients accepted LDT treatment with Low base- line HBsAg level （ ≤ 1500 IU/mL） and high baseline ALT level （ 〉 5 ULN） presented satisfactory responses of HBeAg negative and HBeAg seroeonversion at week 48 ; baseline HBsAg and ALT levels are important forecasting factors of HBeAg seroeonversion with the treatment of telbivudine （LDT）.
出处
《中国微生态学杂志》
CAS
CSCD
2014年第2期184-187,共4页
Chinese Journal of Microecology
