HBeAg/HBeAb双阳性慢性乙型肝炎患者血清HBV RNA的变化及临床转归分析  

Changes and Clinical Outcome of Serum HBV RNA in Patients with HBeAg/HBeAb Double Positive Chronic Hepatitis B

作　　者：杨娟 黄敏[2] Yang Juan;Huang Min(Affiliated Hospital of Chongqing Three Gorges Medical College,Wanzhou,Chongqing 404100;The Affiliated People′s Hospital of Chongqing Three Gorges Medical College,Wanzhou,Chongqing 404100,China)

机构地区：[1]重庆三峡医药高等专科学校附属中医院,重庆万州404100 [2]重庆三峡医药高等专科学校附属人民医院,重庆万州404100

出　　处：《四川医学》2024年第6期650-654,共5页Sichuan Medical Journal

摘　　要：目的探讨HBeAg/HBeAb双阳性慢性乙型肝炎(CHB)患者血清HBV RNA的变化及临床转归分析。方法选取2020年6月至2022年8月诊治的102例HBeAg/HBeAb双阳性CHB患者作为研究对象,设立为双阳组,同期选取51例HBeAg阳性、HBeAb阴性的CHB患者和52例HBeAg阴性、HBeAb阳性的CHB患者设立为对照1组和对照2组,对比血清HBV RNA变化。根据治疗方法不同将双阳组分为干扰素组(予以干扰素治疗,n=52)和恩替卡韦组(予以恩替卡韦治疗,n=50),对比HBeAg、HBeAb浓度及HBeAg转阴,HBeAb仍阳性、HBeAg和HBeAb同时转阴、HBeAg未转阴,HBeAb仍阳性占比。结果双阳组的HBV RNA水平均高于对照1、2组(P<0.05)。治疗前,干扰素组和恩替卡韦组的HBeAg、HBeAb、HBV RNA比较,差异无统计学意义(P>0.05),治疗后,干扰素组的HBeAg、HBeAb、HBV RNA低于恩替卡韦组(P<0.05)。干扰素组的HBeAg转阴,HBeAb仍阳性占比高于恩替卡韦组,而HBeAg未转阴,HBeAb仍阳性占比低于恩替卡韦组(P<0.05)。2组HBeAg和HBeAb同时转阴占比比较,差异无统计学意义(P>0.05)。ROC曲线分析显示,HBV RNA预测CHB患者HBeAg/HBeAb双阳性和临床转归不良的AUC值分别为(0.936、0.954,P<0.05);敏感度分别为100.00%、93.10%;特异度分别为88.70%、76.70%。结论HBV RNA在HBeAg/HBeAb双阳性CHB患者中呈高表达趋势,观察其水平变化有助于为预测临床转归提供指导。Objective To explore the changes of serum HBV RNA in patients with HBeAg/HBeAb double-positive chronic hepatitis B(CHB)and analyze the clinical outcome.Methods 102 patients with HBeAg/HBeAb double-positive CHB diagnosed and treated from June 2020 to August 2022 were selected as the research object,and set as the double-positive group.At the same time,51 patients with HBeAg positive and HBeAb negative CHB and 52 patients with HBeAg negative and HBeAb positive CHB were selected as the control group 1 and the control group 2,and the changes of serum HBV RNA were compared.According to different treatment methods,the double-positive group was divided into interferon group(treated with interferon,n=52)and entecavir group(treated with entecavir,n=50).Compared the concentration of HBeAg and HBeAb and the conversion of HBeAg to negative,HBeAb remained positive,HBeAb and HBeAb turned negative at the same time,HBeAg did not turn negative and HBeAb was still positive.Results The level of HBV RNA in the double-positive group was higher than that in the control group 1 and 2(P<0.05).Before treatment,there was no significant difference in RNA levels of HBeAg,HBeAb and HBV between interferon group and entecavir group(P>0.05).After treatment,levels of HBeAg,HBeAb and HBV RNA in interferon group were lower than those in entecavir group(P<0.05).In interferon group,HBeAg turned negative,but HBeAg remained positive,the level of which was higher than that in entecavir group(P<0.05).There was no significant difference between the two groups in the proportion of HBeAg and HBeAb turning negative at the same time(P>0.05).ROC curve analysis showed that the AUC values of HBV RNA predicting HBeAg/HBeAb double positive and poor clinical outcome in CHB patients were(0.936,0.954,P<0.05).The sensitivity was 100.00%and 93.10%respectively.The specificity was 88.70%and 76.70%respectively.Conclusion HBV RNA is highly expressed in patients with HBeAg/HBeAb double positive CHB,and observation of its level changes is helpful to predict the clinical out

关 键 词：HBeAg/HBeAb双阳性 慢性乙型肝炎 HBV RNA 临床转归 

分 类 号：R512.62[医药卫生—内科学]