血清HBsAg和HBeAg定量检测对HBeAg阳性慢性乙型肝炎患者病毒学应答的预测价值  

Predictive value of HBsAg and HBeAg quantitation on virological response of HBeAg-positive chronic hepatitis B patients

作　　者：阎文昭[1] 张岩[2] 刘英辉[1] 甄真[1] 周俊英[1] 

机构地区：[1]河北医科大学第三医院感染科,石家庄050051 [2]河北省沧州市中心医院感染科,061110

出　　处：《国际流行病学传染病学杂志》2016年第3期177-181,共5页International Journal of Epidemiology and Infectious Disease

摘　　要：目的：探讨血清HBsAg和HBeAg定量检测对恩替卡韦治疗HBeAg阳性慢性乙型肝炎患者48周病毒学应答的预测价值。方法选取64例HBeAg阳性慢性乙型肝炎患者应用恩替卡韦0.5 mg/d抗病毒治疗48周，采用电化学发光微粒法检测基线及治疗后12周、24周血清HBsAg和HBeAg变化情况，分析其动态变化与治疗应答的相关性，应用ROC曲线比较预测疗效的价值，确定最佳临界值。结果64例HBeAg阳性慢性乙型肝炎患者随访48周有8例患者发生完全病毒学应答。24周HBeAg〈9.25COI（OR=45.000，P〈0.01，阳性预测值为71.43%，阴性预测值为94.74%），24周HBeAg较基线下降大于97.1%（OR=71.400，P〈0.01，阳性预测值为58.33%，阴性预测值为98.08%）是48周完全应答的预测因素。结论采用恩替卡韦治疗的HBeAg阳性慢性乙型肝炎患者，早期血清HBsAg、HBeAg变化对48周完全应答有预测价值，其中血清HBeAg的下降更有益于疗效的预测。Objective To explore predictive value of HBsAg and HBeAg quantitation on virological response of HBeAg-positive chronic hepatitis B patients 48 weeks after treatment with entecavir. Methods There were 64 HBeAg positive patients enrolled with entecavir （0.5 mg/d） treatment for 48 weeks. Serum HBsAg and HBeAg were determined by electrochemiluminescence immunoassay （ECLIA） and were quantified at baseline and throughout the antiviral therapy period （week 12 and 24）. The relationship between the dynamic changes and the virological response was analyzed, and the predictive values of HBsAg and HBeAg quantitation were compared by ROC curve, in order to determine the best critical value. Results A total of 8 patients achieved complete response among 64 patients. It showed that HBeAg was lower than 9.25COI by week 24 （OR=45.000, P〈0.01, positive predictive value=71.43%, negative predictive value=94.74%）, and HBeAg declined more than 97.1% compared with the baseline by week 24 （OR=71.400, P〈0.01, positive predictive value=58.33%, negative predictive value=98.08%）, which was predictors related to complete response. Conclusions Serum HBsAg and HBeAg levels have predictive value for complete response at 48 weeks of HBeAg positive patients treated with entecavir, and the decline of HBeAg level can better predict antiviral efficacy.

关 键 词：肝炎 乙型 慢性 肝炎e抗原 乙型 肝炎表面抗原 乙型 恩替卡韦 

分 类 号：R512.62[医药卫生—内科学]