替比夫定治疗HBeAg阳性慢性乙型肝炎应答反应与HBeAg/HBsAg比值相关性研究  

A retrospective study of the relationship between the response to telbivudine and the HBeAg/HBsAg ratio in patients with HBeAg-positive chronic hepatitis B

作　　者：孙菡 周新民 尹芳 孙利 Sun Han;Zhou Xinmin;Yi Fang(Department of Infectious Diseases,Xi'an No.3 Hospital,Xi'an 710083)

机构地区：[1]西安市第三医院感染科,西安710083 [2]空军军医大学西京医院消化病院消化八科,西安710032

出　　处：《陕西医学杂志》2018年第9期1137-1140,共4页Shaanxi Medical Journal

摘　　要：目的:观察替比夫定(LDT)治疗HBeAg阳性慢性乙型肝炎(CHB),治疗24周时与应答反应相关的多种因素,探讨HBeAg定量与HBsAg定量比值在预测应答反应的效果及价值。方法:收集采取LDT初治的HBeAg阳性CHB患者97例,在治疗前及治疗24周均进行HBsAg定量、HBeAg定量、HBV–DNA定量、肝功能测定;统计分析基线指标及HBeAg定量与HBsAg定量的比值与治疗24周后病毒学应答反应的相关性;利用Logistic回归建立各指标与24周不同应答反应预测模型,并分析各指标对应答反应的重要性。结果:基线HBeAg定量、基线HBeAg定量/HBsAg定量比值、基线HBV-DNA定量水平与治疗24周应答反应有显著相关性(P<0.05);基线时不同性别、年龄、肝功能水平、HBsAg定量与治疗24周应答反应无相关(P>0.05)。多因素Logistic逐步回归分析显示基线HBeAg定量/HBsAg定量比值进入预测模型,可有效预测应答反应。基线HBeAg/HBsAg比值≥0.2预测LDT治疗24周应答不佳(部分病毒学应答和原发性无应答)的CHB患者灵敏度为62%,特异度为34%。结论:LDT治疗HBeAg阳性CHB患者,基线HBeAg定量/HBsAg定量比值≥0.2是预测24周应答不佳的最强相关因素。Objective:Observing the effects of telbivudine(LDT)in the treatment of HBeAg-positive chronic hepatitis B(CHB)patients,the factors associated with the response response at 24 weeks of treatment,and the effect and value of HBeAg quantification and HBsAg quantitative ratio in predicting response response.Methods:97 patients with HBeAg-positive CHB who were initially treated with LDT were recruited.HBsAg quantification,HBeAg quantification,HBV-DNA quantification,liver function were measured before and at 24 weeks of treatment.Statistical analysis was used to analyze the correlation between baseline indicators and the ratio of HBeAg quantification and HBsAg quantification to virologic response after 24 weeks of treatment.Logistic regression was used to establish various indicators and 24 weeks of different response prediction models,and analyze the importance of each indicator on the response.Results:Baseline HBeAg quantification,baseline HBeAg quantification/HBsAg quantification ratio,and baseline HBV-DNA quantification levels were significantly associated with 24 weeks of response;At baseline,there was no correlation between gender,age,liver function,HBsAg quantification and 24-week response.Multivariate Logistic stepwise regression analysis showed that the baseline HBeAg quantitative/HBsAg quantitative ratio entered the prediction model,which can effectively predict the response.Baseline HBeAg/HBsAg ratio≥0.2 Predicted poor response in CHD patients treated with LDT for 24 weeks with a sensitivity of 62%and a specificity of 34%.Conclnsion:In patients with HBeAg-positive CHB treated with LDT,the baseline HBeAg quantification/HBsAg quantitative ratio≥0.2 is the strongest predictor of 24 weeks of poor response.

关 键 词：乙型肝炎/药物疗法 核苷酸类/治疗应用 @HBeAg定量/HBsAg定量 持续病毒学应答 预测 

分 类 号：R512.6[医药卫生—内科学]