HBeAg定量对聚乙二醇干扰素α治疗慢性乙型肝炎疗效的预测价值  

HBeAg quantification in predicting efficacy of pegylated interferon α therapy for patients with chronic hepatitis B

作　　者：高国生[1] 颜华东[2] 徐晓珍[2] 胡耀仁[2] 

机构地区：[1]浙江省宁波市第二医院检验科,315010 [2]浙江省宁波市第二医院肝病科,315010

出　　处：《中华临床感染病杂志》2013年第6期351-354,共4页Chinese Journal of Clinical Infectious Diseases

基　　金：宁波市自然科学基金

摘　　要：目的 探讨HBeAg定量及其动态变化对聚乙二醇干扰素α治疗HBeAg阳性慢性乙型肝炎(CHB)患者疗效的预测价值。方法 选择2009年3月至2011年12月宁波市第二医院216例HBeAg阳性CHB患者。所有患者经皮下注射聚乙二醇干扰素(PegIFN) α-2a或α-2b治疗,每周一次,疗程为48周,停药后随访24周。根据随访结束时患者HBeAg血清学转换情况将患者分为HBeAg血清学转换组和非转换组,并采用受试者工作特征(ROC)曲线评价治疗基线、12周、24周HBeAg定量以及HBeAg下降幅度对HBeAg血清学转换的预测价值。结果 216例患者中,68例出现HBeAg血清学转换,转换率为31.48％,PegIFNα-2a和α-2b的疗效相差不大(32.00％∶29.27％,P ＞0.05)。HBeAg血清学转换组与非转换组的基线指标中,HBeAg定量的差异有统计学意义(Z=-3.834,P＜0.05)。HBeAg血清学转换组HBeAg定量下降速度较非转换组更快,但差异无统计学意义(F=3.321,P＞0.05)。ROC曲线分析结果显示,治疗24周时HBeAg定量对HBeAg血清学转换的预测价值显著好于其他指标(ROC曲线下面积为0。861)。结论 治疗24周时的HBeAg定量水平是PegIFNα治疗HBeAg阳性CHB疗效的有效预测指标。Objective To evaluate HBeAg quantification in predicting the efficacy of pegylated interferon (PegIFN) α treatment for patients with HBeAg-positive chronic hepatitis B (CHB).Methods A total of 216 HBeAg-positive CHB patients admitted in Ningbo No.2 Hospital during March 2009 and December 2011 were enrolled in the study.All patients were given subcutaneous injection of PegIFNα-2a or PegIFNα-2b weekly for 48 weeks and followed up for 24 weeks after discontinuation.Patients were divided into HBeAg seroconversion group and non-seroconversion group at the end of the follow-up.Receiver operating characteristic (ROC) curves were used to evaluate HBeAg levels at baseline and 12,24 weeks of treatment in predicting HBeAg seroconversion.Results HBeAg seroconversion was observed in 31.48％ (68/216) patients at the end of follow-up,and there was no significant difference in seroconversion rate between patients treated with PegIFNα-2a and those with PegIFNα-2b (32.00％ vs.29.27％,P ＞ 0.05).There was significant difference in baseline HBeAg levels between patients with HBeAg seroconversion and those without HBeAg seroconversion (Z =-3.834,P ＜ 0.05).HBeAg seroconversion patients had a tendency of rapidly decreasing HBeAg level,but there was no significant difference in decreasing rate between seroconversion and non-seroconversion patients (F =3.321,P ＞ 0.05).ROC curves showed that HBeAg level at 24-week was the best indicator for predicting HBeAg seroconversion with area under curve of 0.861.Conclusion Serum HBeAg level at 24-week of treatment may be used to predict the HBeAg seroconversion in HBeAg-positive CHB patients treated with PegIFNα.

关 键 词：肝炎 乙型 慢性 干扰素Α 肝炎e抗原 乙型 治疗结果 血清学转换 

分 类 号：R512.62[医药卫生—内科学]