慢性乙型肝炎患者血清HBV RNA水平与核苷(酸)类似物治疗时间的关系  

Correlation between serum HBV RNA and duration of treatment with nucleos(t)ide analogues in patients with chronic hepatitis B

作　　者：范雪莉 詹爱琴[2] 安轶 田丽艳 FAN Xueli;ZHAN Aiqin;AN Yi;TIAN Liyan(Shihezi University School of Medicine,Shihezi,Xinjiang 832000,China;Department of Infectious Diseases,The First Affiliated Hospital of Shihezi University School of Medicine,Shihezi,Xinjiang 832000,China;The First Clinical College of China Medical University,Shenyang 110001,China)

机构地区：[1]石河子大学医学院,新疆石河子832000 [2]石河子大学医学院第一附属医院感染科,新疆石河子832000 [3]中国医科大学第一临床学院,沈阳110001

出　　处：《临床肝胆病杂志》2024年第1期58-63,共6页Journal of Clinical Hepatology

基　　金：中国肝炎防治基金会天晴肝病研究基金(TQGB20170175)。

摘　　要：目的检测未治疗和经过治疗的慢性乙型肝炎(CHB)患者血清HBV RNA水平,并分析血清HBV RNA水平与核苷(酸)类似物(NAs)抗病毒治疗时间的关系。方法选取2022年2月—2022年7月间就诊于石河子大学医学院第一附属医院感染科门诊患者中的300例CHB患者为研究对象。收集患者临床资料,根据患者抗病毒治疗时间不同分为未治疗组(n=73)、治疗时间≤1年组(n=91)、治疗时间>1年组(n=136),检测患者血清HBV RNA和HBV DNA载量及HBsAg浓度。计量资料两组间比较采用Mann-Whitney U检验,多组间比较采用Kruskal-Wallis H检验,进一步两两比较采用Bonferroni校正法;计数资料用χ^(2)检验,采用Spearman相关分析比较各指标间相关程度。结果HBeAg阳性率18.3%,在HBV DNA阴性者中HBV RNA阳性者占比44.1%(86/195)。HBeAg阳性组和HBeAg阴性组患者血清HBV RNA、HBV DNA、HBsAg水平分布差异均具有统计学意义(Z值分别为10.740、6.300、7.280,P值均<0.05)。未治疗组与治疗时间≤1年组仅有DNA水平分布情况有统计学差异(P<0.05),未治疗组与治疗时间>1年组HBV RNA、HBV DNA水平分布差异均有统计学意义(P值均<0.05),治疗时间≤1年与治疗时间>1年组中HBV RNA、HBV DNA、HBsAg水平分布情况差异均有统计学意义(P值均<0.05)。抗病毒治疗时间与HBV RNA、HBsAg水平呈极弱负相关(r值分别为-0.247、-0.138,P值均<0.05),与HBV DNA水平呈强负相关(r=-0.771,P<0.001)。血清HBV RNA与HBV DNA、HBsAg水平呈低度相关(r值分别为0.360、0.442,P值均<0.001),进一步分层分析显示,在未治疗组中,HBV RNA与HBV DNA水平呈强正相关(r=0.752,P<0.001),与HBsAg水平呈中度正相关(r=0.559,P<0.001);在治疗时间≤1年组中,HBV RNA与HBV DNA、HBsAg水平呈低度正相关(r值分别为0.396、0.388,P值均<0.001);在治疗时间>1年组中,HBV RNA与HBsAg水平呈低度正相关(r=0.352,P<0.001)。结论血清HBV RNA与NAs治疗时间呈负相关,与HBV DNA、HBsAg水平的相关性�Objective To investigate the serum level of HBV RNA in untreated or treatment-experienced patients with chronic hepatitis B(CHB)and the correlation between serum HBV RNA level and the duration of antiviral therapy with nucleos(t)ide analogues(NAs).Methods A total of 300 patients with CHB who attended Department of Infectious Diseases in The First Affiliated Hospital of Shihezi University School of Medicine from February to July,2022,were enrolled as subjects.Related clinical data were collected,and according to the duration of antiviral therapy,they were divided into untreated group with 73 patients,treatment duration≤1 year group with 91 patients,and treatment duration>1 year group with 136 patients.Serum HBV RNA load,HBV DNA load,and HBsAg concentration were measured for all patients.The Mann-Whitney U test was used for comparison of continuous data between two groups,and the Kruskal-Wallis H test was used for comparison between multiple groups,further pairwise comparison using Bonferroni method;the chi-square test was used for comparison of categorical data;a Spearman correlation analysis was used to investigate the degree of correlation between various indicators.Results The positive rate of HBeAg was 18.3%,and among the patients with negative HBV DNA,the patients with positive HBV RNA accounted for 44.1%(86/195).There was a significant difference in the distribution of the serum levels of HBV RNA,HBV DNA,and HBsAg between the positive HBeAg group and the negative HBeAg group(Z=10.740,6.300,and 7.280,all P<0.05).There was a significant difference in the distribution of DNA level between the untreated group and the treatment duration≤1 year group(P<0.05);there was a significant difference in the distribution of HBV RNA and HBV DNA levels between the untreated group and the treatment duration>1 year group(P<0.05);there was a significant difference in the distribution of HBV RNA,HBV DNA,and HBsAg levels between the treatment duration≤1 year group and the treatment duration>1 year group(P<0.05).The correlat

关 键 词：乙型肝炎 慢性 核苷类 核苷酸类 

分 类 号：R512.62[医药卫生—内科学]