慢性乙型肝炎患者抗病毒治疗中血清HBV RNA水平变化与HBeAg阳性及肝硬化的关系  

Relationships between changes in serum HBV RNA levels and HBeAg positivity and cirrhosis in patients with CHB during antiviral therapy

作　　者：蔡纲 高庆娥 CAI Gang;GAO Qing´e(Infectious Diseases Department,Zibo Fourth People's Hospital(Zibo Infectious Diseases Hospital),Zibo 255022,China)

机构地区：[1]淄博市第四人民医院(淄博市传染病医院)感染科,山东淄博255022

出　　处：《山东医药》2025年第1期104-108,共5页Shandong Medical Journal

基　　金：山东省淄博市医药卫生科研项目(20240308025)。

摘　　要：目的探讨慢性乙型肝炎(CHB)患者抗病毒治疗中血清乙型肝炎病毒(HBV)RNA水平变化与乙型肝炎病毒e抗原(HBeAg)及肝硬化的关系。方法选择核苷(酸)类似物抗病毒治疗中的CHB患者491例,其中HBeAg阳性206例、阴性285例,有肝硬化117例、无肝硬化374例。用全自动荧光定量PCR分析仪检测血清HBV DNA,用全自动核酸检测分析系统检测血清HBV RNA。二分类多因素非条件Logistic回归分析HBV RNA阳性对CHB患者抗病毒治疗中HBeAg阳性、肝硬化的影响,用Pearson相关法分析血清HBV RNA水平与HBV DNA水平的相关性。结果HBeAg阳性患者年龄小于HBeAg阴性患者(P<0.05),HBV RNA阳性率、HBV DNA阳性率及HBV RNA、HBV DNA水平高于HBeAg阴性患者(P均<0.05)。肝硬化患者年龄大于无肝硬化患者(P<0.05),HBV DNA阳性率、HBV DNA水平低于无肝硬化患者(P均<0.05)。肝硬化患者与无肝硬化患者性别、HBV RNA阳性率、HBV RNA水平比较差异无统计学意义(P均>0.05)。年龄小、HBV DNA阳性、HBV RNA阳性是CHB患者抗病毒治疗中HBeAg阳性的危险因素(P均<0.05)。男性、年龄大、HBV DNA阳性、HBV RNA阳性是CHB患者抗病毒治疗中肝硬化的危险因素(P均<0.05)。CHB患者血清HBV RNA水平与HBV DNA水平呈正相关(P均<0.05)。结论HBV RNA阳性是CHB患者抗病毒治疗中HBeAg阳性、肝硬化的危险因素,HBV RNA检测可作为HBV DNA评估病毒复制活性的有效补充。Objective To investigate the relationships between changes in serum hepatitis B virus(HBV)ribonucleic acid(RNA)levels and HBV e antigen(HBeAg)positivity as well as cirrhosis in patients with chronic hepatitis B(CHB)during nucleos(t)ide analogue(NA)antiviral therapy.Methods Totally 491 patients with CHB receiving NA antiviral therapy were enrolled,including 206 HBeAg-positive patients and 285 HBeAg-negative patients,as well as 117 cirrhotic patients and 374 non-cirrhotic patients.Serum HBV deoxyribonucleic acid(DNA)was quantified using an automated fluorescence quantitative polymerase chain reaction(PCR)analyzer,and serum HBV RNA was measured using an automated nucleic acid detection analysis system.The binary multivariate unconditional Logistic regression analysis was performed to evaluate the effect of HBV RNA positivity on HBeAg positivity and cirrhosis in these patients.Pearson correlation analysis was used to explore the correlation between serum HBV RNA and HBV DNA levels.Results HBeAg-positive patients were younger than HBeAg-negative patients(P<0.05).The positivity rates and levels of HBV RNA and HBV DNA were higher in HBeAg-positive patients than in HBeAg-negative patients(all P<0.05).Patients with cirrhosis were older than those without cirrhosis(P<0.05)and had lower HBV DNA positivity rates and HBV DNA levels(all P<0.05).There were no significant differences between patients with and without cirrhosis in terms of sex,HBV RNA positivity rates,or HBV RNA levels(all P>0.05).Younger age,HBV DNA positivity,and HBV RNA positivity were risk factors for HBeAg positivity during NA therapy(all P<0.05).Male sex,older age,HBV DNA positivity,and HBV RNA positivity were risk factors for cirrhosis during NA therapy(all P<0.05).Serum HBV RNA levels were positively correlated with HBV DNA levels(P<0.05).Conclusions Positive HBV RNA is a risk factor for HBeAg positivity and cirrhosis in patients with CHB during NA therapy.Detection of HBV RNA can serve as an effective supplement to HBV DNA in assessing the viral replicat

关 键 词：慢性乙型肝炎 肝硬化 乙型肝炎病毒 乙型肝炎病毒核糖核酸 乙型肝炎病毒E抗原 抗病毒治疗 

分 类 号：R512.6[医药卫生—内科学]