慢性乙型肝炎患者血清HBsAg与单个核细胞乙型肝炎病毒RNA水平对聚乙二醇干扰素治疗效果的预测价值  

Utility of serum HBsAg and peripheral blood mononuclear cell HBV RNA in predicting the treatment effect of pegylated interferonα-2b in patients with chronic hepatitis B

作　　者：席文娜[1] 罗飞兵 吴昭 余东山[1] XI Wenna;LUO Feibing;WU Zhao;YU Dongshan(Department of Infectious Diseases,the Second AffiliatedHospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院感染科,南昌330006 [2]南昌大学第二附属医院检验科,南昌330006 [3]丰城市人民医院感染科

出　　处：《中国感染与化疗杂志》2024年第2期184-189,共6页Chinese Journal of Infection and Chemotherapy

基　　金：江西省卫生健康委科技计划(20204250;20204246)。

摘　　要：目的探讨慢性乙型肝炎患者外周血清HBsAg、乙型肝炎病毒(HBV)DNA与血清HBV RNA及单个核细胞(PBMC)HBV RNA的关系。方法50例慢性乙型肝炎患者,给予Peg-IFNα-2b 180μg皮下注射,每周一次,分别在初始治疗、24周和48周,检测患者血清HBV五项、肝功能、HBV DNA、HBV RNA及PBMC中HBV RNA的变化。结果患者三个时间段的生化指标ALT、AST、TBIL、AKP及GGT比较差异无统计学意义(P>0.05);免疫学标志物HBsAg、HBsAb、HBeAg、HBeAb差异有统计学意义(P<0.05);血清HBV DNA及HBV RNA与PBMC HBV RNA差异有显著统计学意义(P<0.001)。结论Peg-IFNα-2b抗病毒治疗各时间段,肝功能转氨酶无显著变化;治疗24周,血HBsAg、HBV DNA与HBV RNA及PBMC HBV RNA快速下降,有显著相关性;治疗48周,血清HBsAg、HBV DNA与HBV RNA及PBMC HBV RNA相关性减弱。因此,24周HBV RNA下降幅度优于48周,更能预测临床治愈。Objective To investigate the relationship between serum HBV markers(HBsAg,HBV DNA and HBV RNA)and peripheral blood mononuclear cell(PBMC)HBV RNA in patients with chronic hepatitis B(CHB)receiving pegylated interferonα-2b(Peg-IFNα-2b).Methods A total of 50 CHB patients received Peg-IFNα-2b 180μg weekly by subcutaneous injection.Serum markers of hepatitis B including HBV DNA and HBV RNA,liver function tests,and PBMC HBV RNA were evaluated before treatment,and after treatment for 24 and 48 weeks,respectively.Results The liver function tests including alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),alkaline phosphatase(AKP),and gamma-glutamyl transpeptidase(GGT)did not show significant differences after treatment from 0 to 48 weeks(P>0.05).The serum markers HBsAg,HBsAb,HBeAg and HBeAb showed significant changes after treatment(P<0.05).Significant change was observed for serum HBV DNA,HBV RNA and PBMC HBV RNA from 0 to 48 weeks of treatment(P<0.001).Conclusions Liver function tests did not show significant change during Peg-IFNα-2b treatment for 48 weeks.Serum HBsAg,HBV DNA,HBV RNA,and PBMC HBV RNA decreased rapidly after treatment for 24 weeks.Improvement of these markers were correlated significantly with Peg-IFNα-2b treatment.The intensity of the correlation decreased after treatment for 48 weeks.Therefore,the decrease of HBV RNA after 24-week treatment is a better indicator predictive of clinical cure than the reduction of HBV RNA after 48-week treatment.

关 键 词：乙型肝炎病毒RNA 单个核细胞乙型肝炎病毒RNA Peg-IFNα-2b 慢性乙型肝炎 

分 类 号：R512.62[医药卫生—内科学]