血清HBsAg、HBV RNA水平对慢性乙型肝炎患者核苷(酸)类药物治疗停药预测的价值  

Values of Serum HBsAg and HBV RNA Levels in Prediction of Discontinuation of Nucleoside(Acid)Therapy in Chronic Hepatitis B Patients

作　　者：吴宝灵[1] 徐龙[1] 余海滨[1] 徐贞秋[1] 吴敏[1] 张伟[1] 范声春 李艳艳[1] 李金明[1] WU Bao-ling;XU Long;YU Hai-bin;XU Zhen-qiu;WU Min;ZHANG Wei;FAN Sheng-chun;LI Yan-yan;LI Jin-ming(Hepatology DepartmentⅡ,Nanchang Ninth Hospital,Nanchang 330002,China)

机构地区：[1]南昌市第九医院肝二科,南昌330002

出　　处：《实用临床医学（江西）》2023年第5期1-4,共4页Practical Clinical Medicine

基　　金：江西省卫健委西医类一般项目(20202023)。

摘　　要：目的探讨血清乙型肝炎表面抗原(HBsAg)定量、乙型肝炎病毒核糖核酸(HBV RNA)水平对慢性乙型肝炎(CHB)患者核苷(酸)类似物(NAs)药物治疗停药预测的价值。方法回顾性分析南昌市第九医院肝病科接受NAs治疗且符合停药标准有计划停药的80例CHB患者的临床资料,选择停药时乙型肝炎病毒脱氧核糖核酸(HBV DNA)<20 U·mL^(-1),HBsAg定量<200 U·mL^(-1)和HBsAg定量200~1000 U·mL^(-1)的患者各40例进行随访,同时观察HBsAg定量<200 U·mL^(-1)、HBV RNA<100 U·mL^(-1)的患者3年复发情况。结果停药3年后,在HBV DNA<20 U·mL^(-1)的前提下,HBsAg定量<200 U·mL^(-1)、HBV RNA<100 U·mL^(-1)的CHB患者复发率为14,3%(5/35),其余患者的复发率为46,7%(21/45),差异有统计学意义(P<0.05)。结论血清HBsAg定量和HBV RNA水平可以预测安全停药,在HBV DNA<20 U·mL^(-1)的前提下,HBsAg定量<200 U·mL^(-1)、HBVRNA<100 U·mL^(-1)的患者可以安全停药。Objective To explore the values of serum hepatitis B surface antigen(HBsAg)and HBV RNA levels in predicting withdrawal of nucleoside(acid)analogues(NAs)in patients with chronic hepatitis B(CHB).Methods A retrospective analysis was conducted on 80 CHB patients who met the withdrawal criteria and received planned withdrawal of NAs in the department of hepatology of our hospital.Forty patients with HBV DNA<20 U·mL^(-1),HBsAg quantification<200 U·mL^(-1),and HBsAg quantification between 200 and 1000 U·mL^(-1) at drug withdrawal were selected for follow-up.At the same time,the 3-year recurrence rate of patients with HBsAg quantification<200 U·mL^(-1) and HBV RNA<100 U·mL^(-1) was observed.Results After discontinuation of medication for 3 years,under the premise of HBV DNA<20 U·mL^(-1),the recurrence rate of CHB among patients with HBsAg quantification<200 U·mL^(-1) and HBVRNA<100 U·mL^(-1)(14.3%,5/35)was significantly lower than that among other patients(46.7%,21/45)(P<0.05).Conclusion Serum HBsAg quantification and HBVRNA levels can predict safe discontinuation of medication.Patients with HBsAg quantification<200 U·mL^(-1) and HBV RNA<100 U·mL^(-1) can safely discontinue medication under the premise of HBV DNA<20 U·mL^(-1).

关 键 词：乙肝表面抗原 乙肝病毒核糖核酸 慢性乙型肝炎 核苷(酸)类药物 停药 

分 类 号：R512.62[医药卫生—内科学]