慢性乙型肝炎患者5年阿德福韦酯疗程中HBsAg水平变化及其与HBVDNA水平相关性分析  

Changes of HBsAg level and its correlation with HBV DNA in patients with chronic hepatitis B undergoing adefovir dipivoxil therapy for five years

作　　者：谭朝霞[1] 况雪梅[1] 丁世涛[1] 邓国宏[1] 何登明[1] 

机构地区：[1]第三军医大学西南医院全军感染病研究所,重庆400038

出　　处：《国际检验医学杂志》2012年第22期2695-2697,共3页International Journal of Laboratory Medicine

基　　金：国家自然科学基金资助项目(81071694)

摘　　要：目的了解慢性乙型肝炎(简称乙肝)患者阿德福韦酯治疗过程中血清HBsAg水平变化,并探讨其与HBVDNA水平的相关性及临床意义。方法对阿德福韦酯治疗5年的20例HBeAg阳性慢性乙肝患者进行HBV基因型检测,并于服药0、8、12、24、52、104、156、208、260周时进行HBVDNA、HBsAg定量检测。结果阿德福韦酯治疗5年对总体HBsAg水平影响不大(P=0.658)。0周HBsAg水平与HBVDNA水平呈负相关(r=-0.603,P=2.13×10-4);其余各时间点中,仅52周时可见二者呈负相关(r=-0.434,P=0.008);12例HBV基因B型患者仅在0周时呈负相关(r=-0.657,P=0.003),8例C基因型患者0、52周时呈负相关(r=-0.643,P=0.026;r=-0.857,P=0.003);考虑ALT水平时,二者负相关则仅表现在ALT<2×ULN者(r=-0.648,P=0.016)。结论阿德福韦酯治疗5年对HBsAg总体水平无影响;HBsAg水平和HBVDNA水平的负相关性仅存在于未予抗病毒治疗且ALT低水平者;抗病毒治疗过程中评价二者相关性的意义不大。Objective To observe the dynamic correlation between levels of HBsAg and DNA of hepatitis B virus（HBV） in chronic hepatitis B（CHB） patients undergoing adefovir dipivoxil therapy for five years. Methods Twenty CHB patients treated with adefovir dipivoxil for 5 years were enrolled in this study and detected for HBV genotypes. Serum levels of HBsAg and HBV DNA were detected at 0,8,12,24,52,104,156,208 and 260 weeks during the treatment. Results Five years adefovir dipivoxil treatment had no significant effect on the overall level of HBsAg（P= 0. 658）. There was a negative correlation between HBsAg and H BV DNA level at 0 and 52 week（r=- 0. 603, P = 2.13 × 10-4 ;r=--0. 641, P = 0.004, respectively）. Within the i 2 cases carrying HBV of genotype B, the negative correlation was observed at 0 week（r=--0. 657, P= 0. 003）. Meanwhile, within the rest of; 8 cases carrying genotype C, the negative correlation was observed at 0 and 52 weeks（r= -0. 643, P = 0. 026 ;r=- 0. 857, P = 0. 003, re- spectively）. Furthermore, the negative correlation was only seen in the group with ＇ALT≤× ULN（r=- 0. 648, P= 0.016）. Con- clusion Five years adefovir dipivoxil therapy might have no significant impact on HBsAg level. The negative cot.relation between HBsAg and HBV DNA level at baseline could only be seen in the patients with lower ALT levels. It might be without significance to evaluate the correlation between HBsAg and HBV DNA level during antiviral treatment.

关 键 词：肝炎表面抗原 乙型 DNA 病毒 肝炎病毒 乙型 化学发光测定法 抗病毒药 

分 类 号：R512.62[医药卫生—内科学]