摘要
目的探讨提高乙型肝炎病毒的脱氧核糖核酸(HBV DNA)灵敏度检测对慢性乙型肝炎低病毒血症(LLV)的临床价值。方法收集自2016年9月至2023年1月期间在我科门诊部及住院部经规律抗病毒治疗至少48周后仍存在低病毒血症的慢性乙型肝炎患者50例,通过调整抗病毒治疗方案,后续随访观察至少3个月~1年,观察低病毒血症患者HBV DNA的阴转情况,按HBV DNA是否改善、转阴情况分为改善组(4例)、转阴组(41例)、失败组(5例)。结果50例低病毒血症患者中改善组和转阴组、失败组占比分别为8.00%、82.00%、10.00%,转阴组明显高于其他两组。男性、病程≥2年、联合应用抗病毒药物的患者明显有着更高的HBV DNA转阴率(P<0.05)。失败组和改善组其HBV DNA水平治疗前后对比有差异(P<0.05);ALT、AST治疗前后对比无明显差异(P>0.05)。结论通过提高血清HBV DNA灵敏度检测,及时发现并诊断慢性乙型肝炎抗病毒治疗中的低病毒血症患者,积极调整抗病毒治疗方案后,能显著提高低病毒血症患者的HBV DNA转阴率。
Objective To explore the clinical value of improving HBV DNA sensitivity detection for chronic hepatitis B hypoviremia.Methods Fifty patients with chronic hepatitis B who still had hypoviremia after regular antiviral treatment for at least 48 weeks were collected from September 2016 to January 2023 in the outpatient department and inpatient department of our Department.After adjusting the antiviral treatment regimen,the HBV DNA negative conversion in patients with hypoviremia was observed for at least 3 months to 1 year.According to whether HBV DNA was improved or not and the condition of negative transformation,HBV DNA was divided into improvement group(4 cases),negative transformation group(41 cases)and failure group(5 cases).Results Among 50 patients with hypoviremia,the proportion of improvement group,negative group and failure group was 8.00%,82.00%and 10.00%,respectively,and the negative group was significantly higher than the other two groups.Male patients,patients with disease duration≥2 years and patients with combination of antiviral drugs had significantly higher HBV DNA negative conversion rate(P<0.05).The HBV DNA levels in the failure group and the improvement group were different before and after treatment(P<0.05).There was no significant difference in ALT and AST before and after treatment(P>0.05).Conclusions By improving serum HBV DNA sensitivity detection,timely detection and diagnosis of patients with hypoviremia in chronic hepatitis B antiviral therapy and active adjustment of antiviral therapy can significantly improve the HBV DNA negative rate in patients with hypoviremia.
作者
陶学萍
李丽娇
漆阳红
欧书强
邓勇
李根
邱艳
TAO Xueping;LI Lijiao;QI Yanghong;OU Shuqiang;DENG Yong;LI Gen;QIU Yan(Department of Infectious Disease,the Second People's Hospital of Pingxiang City,Pingxiang 337000,China)
出处
《中国医药指南》
2023年第33期1-4,共4页
Guide of China Medicine
基金
江西省卫生健康委科技计划:202311744。
