HBsAg定量检测对恩替卡韦治疗HBeAg阴性慢性乙型肝炎患者停药后复发的预测效能  

Predictive efficiency of quantitative detection of HBsAg on relapse of chronic hepatitis B patients with negative HBeAg treated with Entecavir

作　　者：汤雄 黄洁 TANG Xiong;HUANG Jie(Department of Liver Diseases,the Third People′s Hospital of Jiujiang City,Jiangxi Province,Jiujiang332000,China)

机构地区：[1]江西省九江市第三人民医院肝病科

出　　处：《中国当代医药》2020年第4期36-39,共4页China Modern Medicine

基　　金：江西省卫生计生委中医药科研课题(2017A250)

摘　　要：目的探讨乙型肝炎病毒表面抗原(HBsAg)定量检测对恩替卡韦治疗乙型肝炎病毒e抗原(HBeAg)阴性慢性乙型肝炎患者停药后复发的预测效能。方法回顾性分析2016年1月~2017年1月我院收治的83例使用恩替卡韦治疗并达到停药标准的门诊慢性乙型肝炎患者的临床资料,按照随访1年是否发生病毒学复发情况,分为复发组(60例)和未复发组(23例)。比较复发组和未复发组的临床资料;比较复发组停药6、12个月的不同HBsAg定量水平复发程度;分析HBsAg定量预测复发组恩替卡韦停药后的诊断效能。结果复发组的基线丙氨酸氨基转移酶(ALT)和停药时HBsAg定量水平高于未复发组,差异均有统计学意义(P<0.05);两组的性别、年龄、基因型别、肝硬化发生率和基线乙肝病毒DNA(HBV DNA)比较,差异无统计学意义(P>0.05)。复发组停药12个月的不同HBsAg定量水平复发率高于停药6个月,差异有统计学意义(P<0.05)。HBsAg定量预测恩替卡韦停药复发的曲线下面积(AUC)为0.911(95%CI:0.828~0.962),HBsAg定量的最佳截断值为1.957 log10IU/ml,灵敏度与特异性分别为85.00%、98.00%。结论HBsAg定量水平随着复发时间延长,预测意义更大,HBsAg定量检测预测恩替卡韦停药后复发具有较高的诊断效能。Objective To investigate the predictive efficiency of quantitative detection of Hepatitis B virus surface antigen(HBsAg)on the relapse of entecavir in patients with Hepatitis B virus antigen(HBeAg)negative chronic hepatitis B after discontinuation.Methods The clinical data of 83 outpatients with chronic hepatitis B treated with Entecavir from January 2016 to January 2017 were analyzed retrospectively,the patients were divided into relapse group(60 cases)and non relapse group(23 cases)according to the follow-up of 1 year,whether there was virological recurrence or not.The clinical data of relapse group and non relapse group were compared.The recurrence degree of HBsAg were compared in the relapse group at 6 and 12 months after drug withdrawal.Quantitative prediction of diagnostic efficacy of entecavir in relapsed group by HbsAg was analyzed.Results The baseline alanine aminotransferase(ALT),and HBsAg quantitative levels at the time of withdrawal were higher in the relapse group than those in the non-relapse group,the differences were statistically significant(P<0.05).There were no significant differences in gender,age,genotype,and incidence of cirrhosis and baseline Hepatitis B virus DNA(HBV DNA)between the two groups(P>0.05).The recurrence rate of different HBsAg quantitative levels in the relapse group at 12 months of discontinuation were higher than those at the 6 months of discontinuation,the difference was statistically significant(P<0.05).The area under the curve(AUC)for quantitative prediction of HBsAg discontinuation of entecavir withdrawal was 0.911(95%CI:0.828-0.962).The optimal cutoff value for HBsAg quantification was 1.957 log10IU/ml,and the sensitivity and specificity were 85.00%and 98.00%,respectively.Conclusion Quantitative HBsAg level is more significant with the relapse time,and HBsAg quantitative detection has a higher diagnostic efficacy to predict relapse after entecavir discontinuation.

关 键 词：慢性乙型肝炎 恩替卡韦 乙肝表面抗原定量 停药复发 随访 复发率 

分 类 号：R512.62[医药卫生—内科学]