乙型病毒性肝炎患者抗病毒治疗后复发的影响因素分析  

Influencing factors of recurrence in patients with hepatitis B virus after antiviral therapy

作　　者：王振华[1] 杨晓莉[2] 李剀[1] 王鹏 Wang Zhenhua;Yang Xiaoli;Li Kai;Wang Peng(Department of Infection,Shangqiu Municipal Hospital,Shangqiu First People’s Hospital Branch,Shangqiu 476100,China;Shangqiu Medical College,Shangqiu 476000,China)

机构地区：[1]河南省商丘市立医院商丘市第一人民医院分院感染科,476100 [2]商丘医学高等专科学校,476000

出　　处：《中国实用医刊》2021年第6期34-37,共4页Chinese Journal of Practical Medicine

摘　　要：目的观察乙型病毒性肝炎(HBV)患者抗病毒治疗后复发状况,分析复发的影响因素。方法抽取2015年1月至2017年1月商丘市立医院收治的175例HBV患者,均采用医院自制调查表收集患者资料,全部患者均接受核苷类似物治疗,达到停药标准后停药,停药后继续随访48周,记录患者复发情况,将全部可能的因素纳入,经单因素及多因素分析找出HBVC患者抗病毒治疗后复发可能的影响因素。结果175例HBV患者,经治疗及停药随访期间共有68例发生停药后复发,复发率为38.86%;初步比较复发与未复发患者的基线资料后,将比较差异有统计学意义的各个指标分别作为协变量进行单项回归分析,后将全部资料纳入同时作为协变量,建立多元回归模型,行多项回归分析结果显示,乙肝e抗原(HBeAg)阴性、饮酒史、治疗前HBV DNA载量及停药前乙肝表面抗原(HBsAg)定量水平过表达均是HBV患者停药后复发的影响因素(OR>1,P<0.05)。结论HBV患者接受抗病毒治疗后,仍有较高的复发风险,复发与HBeAg阴性、饮酒史、治疗前HBV DNA载量及停药前HBsAg定量水平过表达有关,可针对上述因素,在抗病毒治疗期间为患者实施合理的干预,以减少停药后复发。Objective To observe the recurrence in patients with hepatitis B virus(HBV)after antiviral therapy,analyze the influencing factors of recurrence.Methods A total of 175 cases of HBV patients admittde Shangqiu Municipal Hospital from January 2015 to January 2017 were selected,the data of patients were collected by self-made questionnaire,all patients were treated with nucleoside analogues,the drug was stopped after reaching the drug withdrawal standard,then the follow-up was continued for 48 weeks,the recurrence of the patients was recorded,all possible factors were taken into account,univariate and multivariate analysis were used to find out the possible influencing factors of recurrence in patients with HBVC after antiviral therapy.Results Among the 175 cases of patients with HBV,68 cases recurred after treatment and during the period of follow-up after drug withdrawal,the recurrence rate was 38.86%;after the baseline data of patients with recurrence and non recurrence were compared,the indexes with statistical significance were taken as covariates for single regression analysis,and then all the data were included as covariates at the same time,multiple regression model was established and multiple regression analysis was conducted,the results showed that negative hepatitis B e antigen(HBeAg),drinking history,HBV DNA load before treatment and HBsAg quantitative level overexpression before drug withdrawal were the influencing factors of recurrence in patients with HBV after drug withdrawal(OR>1,P<0.05).Conclusions HBV patients still have a high risk of recurrence after antiviral treatment,which is related to HBeAg negative,drinking history,HBV DNA load before treatment and HBsAg quantitative level overexpression before drug withdrawal,according to the above factors,reasonable intervention can be implemented for patients during antiviral treatment to reduce the recurrence after drug withdrawal.

关 键 词：乙型病毒性肝炎 核苷类似物 复发 

分 类 号：R512.62[医药卫生—内科学]