恩替卡韦对慢性乙型病毒性肝炎患者HBV DNA、HBsAg及HBeAg定量的影响  

Influence of entecavir on quantification of HBV DNA,HBsAg and HBeAg in patients with chronic hepatitis B

作　　者：彭凤英[1] 车小琼[1] 赵宏斌[1] 

机构地区：[1]重庆医科大学附属第一医院感染科,重庆400016

出　　处：《实用临床医药杂志》2016年第7期41-44,共4页Journal of Clinical Medicine in Practice

基　　金：重庆市教委科技项目(KJ070317)

摘　　要：目的观察恩替卡韦对慢性乙型病毒性肝炎(CHB)患者血清乙肝病毒DNA(HBV-DNA)、乙肝表面抗原(HBs Ag)、乙肝e抗原(HBe Ag)定量的影响。方法选取CHB患者160例,均给予恩替卡韦0.5 mg/d空腹口服,持续治疗96周。观察所有患者治疗前、治疗12、24、48及96周后HBV DNA、HBs Ag、HBe Ag定量以及谷氨酸氨基转移酶(ALT)水平,计算HBV DNA、HBe Ag转阴率及ALT复常率,分析HBV DNA变化与HBs Ag、HBe Ag、ALT的相关性。结果随治疗时间延长,患者HBV DNA、HBe Ag定量及ALT水平逐渐降低(F=11.562、28.034、22.417,P<0.01);HBe Ag转阴率、HBV DNA转阴率以及ALT复常率逐渐增加;治疗前、治疗12及24周时,HBV DNA与HBs Ag滴度负相关(r=-0.383、-0.293、-0.224,P<0.05或P<0.01)、与HBe Ag滴度正相关(r=0.441、0.392、0.326,P<0.05或P<0.01)。结论恩替卡韦治疗CHB疗效确切,可有效促进HBV DNA、HBe Ag转阴率及ALT复常。治疗早期,HBV DNA与HBs Ag负相关、与HBe Ag呈正相关,治疗后期无显著相关性,治疗过程中,应联合多项指标综合评价疗效。Objective To observe the influence of entecavir on the quantification of serum hepatitis B virus（ HBV） DNA,hepatitis B surface antigen（ HBs Ag） and hepatitis B e antigen（ HBe Ag） in patients with chronic hepatitis B（ CHB）. Methods A total of 160 patients with CHB were selected and treated with oral entecavir 0. 5 mg / d at an empty stomach for 96 weeks continuously. The quantification of HBV DNA,HBs Ag and HBe Ag as well as the level of alanine aminotransferase（ ALT） before treatment and 12,24,48 and 96 weeks after treatment were observed to calculate the negative conversion rates of HBV DNA and HBe Ag and the normalization rate of ALT. Relationships between HBV DNA changes and HBs Ag,HBe Ag and ALT were analyzed. Results With the prolonging of therapeutic time,the quantification of HBV DNA and HBe Ag as well as level of ALT reduced gradually（ F = 11. 562,28. 034,22. 417,P〈0. 01）,while negative conversion rates of HBe Ag and HBV DNA as well as normalization rate of ALT increased gradually. Before treatment and12,24 weeks after treatment,HBV DNA was negatively associated with HBs Ag titer（ r =- 0. 383,- 0. 293,- 0. 224,P〈0. 05 or P〈0. 01） and positively correlated with HBe Ag titer（ r = 0. 441,0. 392,0. 326,P〈0. 05 or P〈0. 01）. Conclusion Entecavir has a definite efficacy in the treatment of CHB,and it can effectively improve the negative conversion rate of HBV DNA and HBe Ag and normalization rate of ALT. During the early treatment,HBV DNA is negatively correlated with HBs Ag and positively with HBe Ag,and there is no association between them in the late stage of treatment. Therefore,multiple indexes should be used to comprehensively evaluate the clinical efficacy during treatment.

关 键 词：慢性乙型病毒性肝炎 恩替卡韦 乙肝表面抗原 乙肝E抗原 乙肝病毒DNA 

分 类 号：R512.6[医药卫生—内科学]