HBeAg、HBV-DNA载量及ALT在慢性乙肝患者不同药物治、疗中的变化分析  

Analysis on the changes of HBeAg, HBV-DNA load and ALT for different drugs in the treatment of patients with chronic hepatitis B

作　　者：苏荣[1] 杨延斌[2] 伍芷青 罗娜[1] 何娴[1] 

机构地区：[1]佛山市中医院检验科,广东佛山528000 [2]佛山市中医院统计室,广东佛山528000 [3]佛山市科学技术学院医学检验系,广东佛山528000

出　　处：《现代预防医学》2014年第9期1678-1680,共3页Modern Preventive Medicine

基　　金：广东省佛山市医学类科技攻关项目(201208028)<慢性乙型肝炎患者E抗原不同血清学HBV基因分型及耐药位点的研究>

摘　　要：目的观察HBeAg、HBV-DNA、ALT在恩替卡韦、阿德福韦酯治疗慢性乙型病毒肝炎前后的变化,为临床提供监测2种抗病毒药物疗效的准确数据。方法对2012年1月至12月就诊佛山市某医院肝科门诊的慢性乙型肝炎患者(其中33例使用恩替卡韦治疗,71例使用阿德福韦酯治疗)进行回顾性分析。结果恩替卡韦组HBeAg(-)患者与HBeAg(+)患者病毒学应答率分别为88.9%和53.3%,差异有统计学意义(P<0.05);ALT复常率分别61.5%和62.5%,差异无统计学意义(P>0.05)。阿德福韦酯组HBeAg(+)患者与HBeAg(-)患者的病毒学应答率、ALT复常率比较,差异均无统计学意义(P>0.05)。恩替卡韦和阿德福韦酯对病毒复制量高(HBV-DNA≥1×106copy/ml)的患者都较复制量低的患者病毒应答效果好。结论 HBV-DNA和ALT的检测结果可帮助临床了解乙肝病毒在体内的复制情况和炎症活动性。恩替卡韦和阿德福韦酯对慢性乙肝患者均具有很好的抗病毒效果。由于研究选取治疗时间段的局限性,对治疗药物的长期疗效和耐药性仍不确定,有待今后进一步的跟踪和检测。Objective To observe the change of HBeAg, HBV-DNA, ALT before and after the treatment of chronic hepatitis B by the entecavir, adefovir dipivoxil, for clinical monitoring of two kinds of accurate data on the efficacy of antiviral drugs. Methods Pa- tients with chronic hepatitis B from January to December of 2012 in Foshan Hospital of Traditional Chinese Medicine （including 33 cases in entecavir treatment, 71 cases in adefovir dipivoxil treatment） were retrospectively analyzed. Results The viral response rates of HBeAg （-） patients and HBeAg （＋） patients in entecavir group were 88.9% and 53.3%, respectively, the difference was statisti- cally significant （P〈O.05）; ALT normalization rates were 61.5% and 62.5%, no significant difference （P〉O.05）. The virologic re- sponse, ALT normalization rate of HBeAg （＋） patients and HBeAg （-） patients in adefovir dipivoxil group were not statistically sig- nificant （P〉0.05）. Patients with high levels of viral replication （HBV-DNA 1〉 1 ~ 10s copy/ml） in entecavir and adefovir dipivoxil groups had better viral response effect compared with patients with low viral replication response effect. Conclusion HBV-DNA and ALT test results can help clinicians understand the hepatitis B virus replication in vivo and inflammatory activity. Entecavir and adefovir dipivoxil had good anti-viral effect in chronic hepatitis B patients. Because of the limitations of the study time period, the long-term efficacy and drug resistance remains uncertain, it needs further tracking and detection.

关 键 词：慢性乙型肝炎 乙肝病毒E抗原 HBV—DNA 丙氨酸氨基转移酶 

分 类 号：R183[医药卫生—流行病学]