IFN-α治疗慢性乙型肝炎中出现HBeAg血清学转换的预测因素分析  

Analysis of predictive factors of HBeAg seroconversion in the treatment of chronic hepatitis-B by using IFN-α

作　　者：袁敏[1] 张振华[1] 张礼周[1] 张黄醒[1] 王长泰[1] 李旭[1] 尹华发[1] 

机构地区：[1]安徽医科大学第一附属医院感染病科,安徽合肥230022

出　　处：《中华疾病控制杂志》2014年第7期606-609,共4页Chinese Journal of Disease Control & Prevention

基　　金：国家重大基础研究计划"973"项目(2009CB526411);安徽省卫生厅科研基金(2010C053)

摘　　要：目的观察慢性乙型病毒性肝炎(chronic hepatitis B,CHB)患者治疗后不同时期外周血谷丙转氨酶(alanine aminotransferase,ALT)、乙肝病毒脱氧核糖核酸(hepatitis B virus deoxyribonucleic acid,HBV DNA)、乙肝表面抗原(hepatitis B surface antigen,HBsAg)、乙肝e抗原(hepatitis B e antigen,HBeAg)滴度的变化,并探讨其预测HBeAg血清学转换的价值。方法对72例选择干扰素(interferon,IFN)治疗的HBeAg阳性CHB患者随访48周,在治疗0、12、24、48周收集患者的血清,定量检测HBsAg、HBeAg、HBV DNA、ALT水平。结果基线ALT、HBeAg水平与治疗应答相关。治疗12、24周时HBsAg<4.33、4.07(lg IU/ml),下降率>65%、47%,治疗12、24周时HBeAg<2.38、0.87(lg S/CO),下降率>71%、95%预测治疗48时出现HBeAg血清学转换的敏感性、特异性高(均有P<0.05)。结论 IFN治疗HBeAg阳性CHB患者时,动态监测HBsAg、HBeAg的水平变化能作为预测是否出现HBeAg血清学转换的良好指标。Objective To observe titer changes of ALT,HBV DNA,HBsAg and HBeAg of patients with CHB in different stages after treatment and to discuss its value in predicting HBeAg seroconversion. Methods To quantitatively test the sera levels of HBsAg,HBeAg,HBV DNA,ALT at week 0,12,24,48 by collecting the serum of 72 HBeAg-positive patients treated with alpha-interferon after 48 weeks of follow up study. Results The antiviral response was associated with baseline level of ALT and HBeAg. The HBsAg level decrease to less than 4. 33 lg IU /ml at week 12 and 4. 07 lg IU /ml at week 24 with a declining rate greater than 65% and 47% respectively. HBeAg level was below 2. 38 lg S /CO at week12 and 0. 87 lg S /CO at week 24 with a declining rate over 71% and 95% respectively. Therefore,it is predicted that there will be a high degree of sensitivity and specificity（ P〈 0. 05） in HBeAg seroconversion at week 48. Conclusions The level changes of HBsAg and HBeAg can act as effective predictors for HBeAg seroconversion when HBeAg-positive patients are treated with interferon.

关 键 词：肝炎 慢性 干扰素Α 肝炎e抗原 乙型 治疗结果 

分 类 号：R512.62[医药卫生—内科学] R183[医药卫生—临床医学]