经聚乙二醇干扰素α-2a治疗的慢性乙型肝炎患者血清HBV RNA与其HBeAg血清学转换和病毒学应答的关系及临床意义研究  

Clinical Study on Serum Hepatitis B Virus RNA and HBeAg Seroconversion and Virological Response with Peginterferon Alfa-2a Treatment in Chronic Hepatitis B Patients

作　　者：沈加裙 方静 马春梅 林丽圆 胡继军 SHEN Jia-qun;FANG Jing;MA Chun-mei;LIN Li-yuan;HU Ji-jun(Department of Transfusion,Wuhan Third Hospital,Wuhan 430060,China)

机构地区：[1]武汉市第三医院输血科,武汉430060

出　　处：《微循环学杂志》2021年第4期53-58,共6页Chinese Journal of Microcirculation

摘　　要：目的:探讨慢性乙型肝炎(CHB)患者在接受聚乙二醇干扰素α-2a治疗期间,血清HBV RNA水平对HBeAg血清学转换和病毒学应答的预测价值。方法:共纳入38例首次确诊的CHB患者,并接受6个月的聚乙二醇干扰素α-2a治疗;将其按以下标准进行分组:依据治疗后结果分为病毒学应答组(VR组,n=15)和部分病毒学应答组(PVR组,n=23);根据HBeAg分为HBeAg+血清学转换组(A组,n=14)、HBeAg+血清学非转换组(B组,n=18)和HBeAg阴性组(C组,n=6);并对血清ALT、HBeAg、HBsAg、HBV DNA、HBV RNA和HBV基因型进行检测。结果:治疗前,VR组和PVR组患者血清HBV RNA水平无显著差异(P=0.937);VR组患者治疗后血清HBV RNA水平显著降低(P<0.01);A组和B组患者治疗后血清HBV RNA水平显著降低(P<0.05)。CHB患者血清HBV RNA与HBeAg血清学转换和病毒学应答有关;ROC曲线分析显示,血清HBV RNA水平对CHB患者治疗后HBeAg血清学转换和病毒学应答具有一定的预测价值。结论:聚乙二醇干扰素α-2a治疗期间,HBV RNA水平可以较好的预测CHB患者HBeAg血清学转换和病毒学应答。Objective:To investigate whether HBV RNA can predict virological response or HBeAg seroconversion during peginterferon alfa-2a treatment in chronic hepatitis B patients(CHB).Method:38 treatment-naivepatients with hepatitis B virus were included,and then were treated with peginterferon alfa-2a for six months.The patients were divided into virological response group(VR group,n=15)and partial virological response group(PVR,n=23)according to the virological response;and patients were divided into HBeAg seroconversion group(A group,n=14)and no seroconversion group(B group,n=18),and HBeAg negative group(C group,n=6)according to HBeAg+seroconversion.The levels of serum ALT,HBeAg,HBsAg,HBV DNA,HBV RNA,and HBV genotype were detected.Results:HBV RNA levels were showed no significant difference between the virological response(VR)and partial VR(PVR)groups at baseline(P=0.937).Serum HBV RNA was significantly decreased among patients who achieved a VR after therapy(P<0.001).The levels of HBV RNA in both A group and B group were decreased after treatment(P<0.05).HBV RNA was a factor to affect HBeAg seroconversion and virological response in patients with CHB.Furthermore,serum HBV RNA was an independent indicator for predicting HBeAg seroconversion and virological response.Conclusion:Serum HBV RNA could predict HBeAg seroconversion and virological response during peginterferon alfa-2a treatment.

关 键 词：慢性乙型肝炎 乙型肝炎病毒RNA 病毒学反应 HBEAG血清学转换 聚乙二醇干扰素Α-2A 

分 类 号：R512.62[医药卫生—内科学]