非活动性HBsAg携带者临床特征及自发性HBsAg血清学清除相关因素分析  

Clinical characteristics and related factors of spontaneous HBsAg seroclearance in inactive HBsAg carriers

作　　者：韦新焕[1] 张晶[1] 张卫[2] 柳雅立[1] WEI Xin-huan;ZHANG Jing;ZHANG Wei;LIU Ya-li(Beijing Youan Hospital,Capital Medical University,Beijing 100069,China;Beijing Center for Disease Control and Prevention,Beijing 100013,China)

机构地区：[1]首都医科大学附属北京佑安医院丙型肝炎与中毒性肝病科,100069 [2]北京市疾病预防控制中心

出　　处：《肝脏》2020年第2期128-130,154,共4页Chinese Hepatology

摘　　要：目的了解非活动性HBsAg携带者(inactive HBsAg carriers,IHC)临床特征及自发性HBsAg血清学清除相关因素。方法纳入2009年1月至2015年12月在北京佑安医院就诊且至少随访一次的IHC 289例,所有患者均未接受任何核苷类似物和(或)干扰素抗病毒治疗。将对随访过程中是否出现自发性HBsAg血清学清除患者进行差异比较。结果289例IHC的ALT水平为(21.40±7.64)U/L,血清HBsAg、HBeAg、HBV DNA水平分别为4592.00(2262.00,6741.00)COI、0.10(0.09,0.12)COI和430.05(213.25,824.25)IU/mL。血清HBsAg与HbeAg呈正相关(r=1.86,P<0.01),与年龄呈负相关(r=-1.82,P<0.01),与HBV DNA(r=0.09,P=0.58)无明显相关性。平均随访3年,其中17例(2.60%)患者发生自发性HBsAg血清学清除,年发生率为0.87%,其血清HBsAg、HBeAg、HBV DNA水平明显低于无自发性HBsAg血清学清除者(均P<0.01),而两组之间年龄、性别、肝功能等无明显差异。结论在IHC中,血清HBsAg与HBV DNA水平无明显相关性,血清HBsAg、HBeAg、HBV DNA水平较低者更易发生自发性HBsAg血清学清除。Objective To investigate the clinical characteristics and related factors of spontaneous hepatitis B surface antigen(HBsAg)clearance in inactive HBsAg carriers(IHCs).Methods IHCs in our hospital from January 2009 to December 2015 were enrolled and followed up at least once.None of the patients received any nucleoside analogues and/or interferon antiviral therapy.The differences between patients with and without spontaneous HBsAg clearance during follow-up were retrospectively analyzed.Results A total of 289 IHCs were enrolled in this study,including 161 males(55.71%)with an average age of 46.80 years.The alanine aminotransferase level was 21.40±7.64 U/L,and serum HBsAg,hepatitis B envelope antigen(HBeAg)and hepatitis B virus deoxyribonucleic acid(HBV DNA)levels were 4592.00(2262.00-6741.00)COI,0.10(0.09-0.12)COI and 430.05(213.25-824.25)IU/mL,respectively.Serum HBsAg level was correlated with HBeAg level(r=1.86,P<0.01)and age(r=-1.82,P<0.01),but had no relationship with HBV DNA(r=0.09,P=0.58).During an average follow-up of 3 years,17 patients(2.60%)had spontaneous HBsAg serological clearance,with an annual incidence of 0.87%.The serum levels of HBsAg,HBeAg and HBV DNA in patients with spontaneous HBsAg serological clearance were significantly lower than those in patients without(all P<0.01),but there were no significant differences in gender,age and liver function between the 2 groups.Conclusion There is no significant correlation between serum HBsAg and HBV DNA levels in IHCs.Patients with lower serum levels of HBsAg,HBeAg and HBV DNA are more likely to achieve spontaneous HBsAg serological clearance.

关 键 词：非活动性HBSAG携带者 HBSAG滴度 自发性HBsAg血清学清除 

分 类 号：R512.62[医药卫生—内科学]