慢性乙型肝炎抗病毒治疗与血清HBsAg和HBcrAg水平的变化  

Nucleos(t)ides antiviral therapy and the changes of serum HBsAg and HBcrAg levels in patients with chronic hepatitis B

作　　者：李健[1] 陆伟[2] 张占卿[1,2] 王雁冰[2] 翁齐铖 张智勇 丁荣蓉[2] 周新兰[2] LI Jian;LU Wei;ZHANG Zhanqing;WANG Yanbing;WENG Qicheng;ZHANG Zhiyong;DING Rongrong;ZHOU Xinlan(The First Clinical Medical College, Wenzhou Medical University, Wenzhou,325035;Department of Division II Hepatitis, Shanghai Public Health Clinical Center, Shanghai, 201508;Shanghai Representative Office, Fujirebio Incorporation of Japan, Shanghai, 200336)

机构地区：[1]温州医科大学第一临床医学院,浙江温州325035 [2]上海市公共卫生临床中心肝炎二科,上海201508 [3]日本富士瑞必欧株式会社上海代表处,上海200336

出　　处：《温州医科大学学报》2016年第11期807-812,817,共7页Journal of Wenzhou Medical University

基　　金：上海市卫计委重点科研项目(20134032);国家"十二五"传染病防治重大科技专项(2013ZX10002005)

摘　　要：目的:探讨核苷(酸)类抗病毒治疗与慢性乙型肝炎(CHB)患者血清HBsAg和HBcrAg水平的变化。方法:108例CHB患者入选本研究,其中HBeAg阳性患者分别进入抗病毒组46例和非抗病毒组20例,HBeAg阴性患者进入抗病毒组31例和非抗病毒组11例。血清HBsAg和HBcrAg分别采用化学发光微粒免疫法和化学发光酶免疫法检测。结果:无论HBeAg阳性或阴性患者,抗病毒组与非抗病毒组随访时间差异均无统计学意义(P>0.05);抗病毒组随访起点与终点血清HBsAg和HBcrAg水平差异均有统计学意义(均P<0.05),非抗病毒组随访起点与终点血清HBsAg和HBcrAg水平差异均无统计学意义(均P>0.05);抗病毒组与非抗病毒组从随访起点到终点血清HBsAg下降幅度和下降比例差异均无统计学意义(均P>0.05),从随访起点到终点血清HBcrAg下降幅度和下降比例差异均有统计学意义(P<0.05)。结论:CHB患者的抗病毒治疗能导致显著的血清HBsAg和HBcrAg下降,但只能获得显著的血清HBcrAg下降幅度和下降比例。Objective: To investigate the changes of serum hepatitis B surface antigen (HBsAg) and hepatitisB core-related antigen (HBcrAg) levels in patients with chronic hepatitis B treated with nucleos(t)ides antiviraltherapy. Methods: One hundred and eight patients of chronic hepatitis B patients were enrolled in this study,46 patients and 20 patients of HBeAg-positive patients respectively were divided into the antiviral group and thenon-antiviral group, 31 patients and 11 patients of HBeAg-negative patients respectively were into the antiviralgroup and the non-antiviral group. Serum HBsAg and HBcrAg levels were respectively detected by chemiluminescencemicroparticle immunoassay and chemiluminescence enzyme immunoassay. Results: In both HBeAgpositiveand HBeAg-negative patients, the differences of the follow-up time between antiviral and non-antiviralgroup were no statistically significant (P>0.05); the differences of serum HBsAg and HBcrAg levels betweenthe follow-up start and the follow-up end were statistically significant in antiviral group (P<0.05), and which ofserum HBsAg and HBcrAg levels between the follow-up start and the follow-up end were not statistically significantin non-antiviral group (P>0.05); the differences of serum HBsAg levels decline extent and proportion fromfollow-up start to the follow-up end between antiviral and non-antiviral group were not statistically significant(P>0.05), and which of HBcrAg decline extent and proportion from follow-up start to the follow-up end betweenantiviral and non-antiviral group were statistically significant. Conclusion: The antiviral therapy of CHB patientscan lead to the significant decrease of serum HBsAg and HBcrAg levels, but can only get the significant declineextent and proportion of serum HBcrAg.

关 键 词：慢性乙型肝炎 核苷(酸)类 抗病毒治疗 乙型肝炎表面抗原 乙型肝炎核心相关抗原 

分 类 号：R575.2[医药卫生—消化系统]