基线Anti-HBc联合HBsAg预测聚乙二醇干扰素α-2a在恩替卡韦经治慢性乙型肝炎的治疗应答  

Baseline Anti-HBc Combined with HBs Ag Predicts Treatment Response of Peg-IFNa-2a in Chronic Hepatitis B Patients Receiving Entecavir

作　　者：廖金瑶 陈学福[1] 陈小苹[1] 肖艺 

机构地区：[1]广东省人民医院感染科广东省医学科学院,广州 510080

出　　处：《循证医学》2017年第5期287-292,共6页The Journal of Evidence-Based Medicine

基　　金：广东省中医药局建设中医药强省科研课题资助项目(20141006)

摘　　要：目的探究使用恩替卡韦治疗96周后序贯聚乙二醇干扰素α-2a对慢性乙型肝炎的治疗中基线Anti-HBc在HBeAg血清学转换的预测作用。方法纳入103例经恩替卡韦单药治疗的慢性乙型肝炎患者并将其随机分为对照组和试验组,其中试验组56例,在恩替卡韦治疗基础上序贯聚乙二醇干扰素α-2a,12周后改为单药使用聚乙二醇干扰素α-2a;对照组47例,持续接受单药恩替卡韦治疗。每12周进行血常规、甲状腺功能、肝功能检测;采用电化学发光法检测HBsAg、Anti-HBs、HBeAg、Anti-HBe含量,ELISA检测Anti-HBc,荧光定量PCR法检测HBV DNA含量,并比较治疗48周后两组HBeAg血清转换率和HBsAg消失率。结果治疗12周,对照组HBsAg的中位数值相对稳定,试验组呈下降趋势;治疗48周,试验组较对照组HBeAg血清转换率和HBsAg消失率皆有所提高。结论结合基线Anti-HBc定量和HBsAg可作为预测疗效的指标,观察远期疗效。Objective To investigate the performance of baseline Anti-HBc as a predictor for HBeAgseroconversion in chronic hepatitis B(CHB) patients treated with Peginterferon Interferons α-2 a(Peg-IFNα-2 a)sequentially after Entecavir(ETV)treatment for 96 weeks. Method 103 CHB cases treated with ETV singly wereincluded into this study and divided into control group and experimental group randomly. Among those,56 cases inexperimental group received sequential treatment of Peg-IFNα-2 a on the basis treatment of ETV for 12 weeks,thentreated with Peg-IFNα-2 a alone;47 cases in control group treated with ETV alone continuously. For all patients,examination of blood routine,thyroid and liver functions were performed every 12 weeks;meanwhile,the levels ofHBsAg,Anti-HBs,HBeAg and Anti-HBe were detected by electrochemiluminescence assay,the level of Anti-HBc wasdetected by ELISA,the level of HBV DNA was detected by fluorescent quantitative PCR;and the HBeAg seroconversionrate and HBsAg disappearance rate of CHB were compared between the two groups after 48 weeks treatment. Results After treatment for 12 weeks,the median of HBsAg level in the control group was relatively stable,and decreased inexperimental group. After treatment for 48 weeks,compared with the control group,the rates of HBeAg seroconversionand HBsAg disappearance in the experimental group both increased. Conclusion Baseline Anti-HBc for fixed quantityof HBsAg can be used as an index for predicting the curative effect,and observe the long term efficacy.

关 键 词：慢性乙型肝炎 基线Anti-HBc 聚乙二醇干扰素α?2a 恩替卡韦 

分 类 号：R512.62[医药卫生—内科学]