血清乙型肝炎表面抗原及乙型肝炎病毒RNA水平在预测核苷(酸)类药物治疗慢性乙型肝炎患者停药后复发中的价值  

Study on the prediction of discontinuation of nucleoside(acid)drugs in chronic hepatitis B patients by jointly detecting serum hepatitis B surface antigen and hepatitis B virus RNA levels

作　　者：何小燕[1] 张丽琴[1] 吴天恩[1] 曾瑞丽 叶文峰[1] 黎翠兰 HE Xiaoyan;ZHANG Liqin;WU Tianen;ZENG Ruili;YE Wenfeng;LI Cuilan(Department of Laboratory,Ganzhou People's Hospital,Jiangxi Province,Ganzhou 341000,China)

机构地区：[1]江西省赣州市人民医院检验科,江西赣州341000

出　　处：《中国当代医药》2024年第28期127-130,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202311907)。

摘　　要：目的分析乙型肝炎表面抗原(HbsAg)及乙型肝炎病毒RNA(HBV RNA)水平检测对核苷(酸)类药物(NAs)治疗慢性乙型肝炎(CHB)患者停药后复发的预测效果。方法选取2020年1月至2021年1月在赣州市人民医院使用NAs治疗并达到停药标准的80例CHB患者,展开1年随访,根据有无病毒学复发分为复发组和未复发组。采集两组患者血液标本,展开HBV RNA及HBsAg定量检测,分析HBsAg和HBV RNA定量对NAs药物停药后复发的预测价值。结果80例患者复发率17.50%,复发组的停药时HBV DNA载量、停药时HBsAg定量高于未复发组,差异有统计学意义(P<0.05)。复发组停药6、12、18、24个月,HBsAg及HBV RNA定量水平比较,停药24个月HBsAg及HBV RNA定量水平高于其他时间点,差异有统计学意义(P<0.05)。HBV RNA预测疾病复发的敏感度为85.71%,特异度80.30%,HBsAg对应数值为78.57%、89.39%。结论HBsAg和HBV RNA定量对NAs药物停药后CHB复发有预测价值,值得推广。Objective To analyze the predictive effect of hepatitis B surface antigen(HbsAg)and hepatitis B virus RNA(HBV RNA)levels on the recurrence of chronic hepatitis B(CHB)patients after withdrawal of nucleoside(acid)drugs(NAs).Methods A total of 80 CHB patients who received NAs treatment in Ganzhou People's Hospital from January 2020 to January 2021 and reached the standard of drug withdrawal were selected for 1-year follow-up.They were divided into recurrence group and non-recurrence group according to whether there was virological recurrence.Blood samples of two groups of patients were collected,HBV RNA and HBsAg quantitative detection was carried out,and the values of HBsAg and HBV RNA quantitative detection in predicting relapse after NAs drug withdrawal were analyzed.Results The recurrence rate of 80 patients was 17.50%.The HBV DNA load and HBsAg quantification at discontinuation in the recurrence group were higher than those in the non-recurrence group,with statistical significances(P<0.05).The quantitative levels of HBsAg and HBV RNA were higher in the recurrence group after discontinuation of medication for 6,12,18,and 24 months compared to those at other time points,with statistical significances(P<0.05).The sensitivity of HBV RNA in predicting disease recurrence was 85.71%,the specificity was 80.30%,and the corresponding values of HBsAg were 78.57%and 89.39%.Conclusion HBsAg and HBV RNA quantification have predictive value for CHB recurrence after discontinuation of NAs drugs,and are worth promoting.

关 键 词：慢性乙型肝炎 核苷(酸)类药物 停药 复发 乙型肝炎表面抗原 乙型肝炎病毒RNA 预测效能 

分 类 号：R512[医药卫生—内科学]