基于CR-HepB的中国慢性乙型肝炎患者血清HBsAg水平分布特征  

Distribution characteristics of serum HBsAg levels in Chinese patients with chronic hepatitis B based on CR-HepB

作　　者：陈姝延 单姗[1] 孔媛媛 徐小倩 王皓 吴晓宁[1] 周家玲 王冰琼 孟彤彤 张梦阳 贾继东[1] 孙亚朦[1] 尤红[1] Chen Shuyan;Shan Shan;Kong Yuanyuan;Xu Xiaoqian;Wang Hao;Wu Xiaoning;Zhou Jialing;Wang Bingqiong;Meng Tongtong;Zhang Mengyang;Jia Jidong;Sun Yameng;You Hong(Liver Research Center,Beijing Friendship Hospital,Capital Medical University,State Key Lab of Digestive Health,National Clinical Research Center for Digestive Diseases,Beijing 100050,China;Beijing Friendship Hospital,Capital Medical University,Clinical Epidemiology and EBM Unit,Beijing Clinical Research Institute,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院肝病中心、消化健康全国重点实验室、国家消化系统疾病临床医学研究中心,北京100050 [2]首都医科大学附属北京友谊医院,北京市临床医学研究所临床流行病学与循证医学研究室,北京100050

出　　处：《中华肝脏病杂志》2025年第1期34-40,共7页Chinese Journal of Hepatology

基　　金：国家重点研发计划(2023YFC2306900);国家自然科学基金项目(82300696);北京市属医院科研培育计划项目(PX2024005);首都临床特色诊疗技术研究及转化应用专项(Z221100007422115)。

摘　　要：目的探索国内初治和经治慢性乙型肝炎(CHB)患者HBsAg水平分布特征。方法数据来源于“中国消除乙肝临床研究平台CR-HepB”,纳入从平台建立至2024年4月11日的核苷(酸)类似物(NAs)初治和经治CHB患者,收集相关临床资料。回顾性分析两类人群的乙型肝炎表面抗原(HBsAg)分布情况,以及经不同抗病毒治疗时间后,不同年龄段患者的HBsAg水平分布情况。正态分布计量资料用xˉ±s表示,非正态分布计量资料用M(Q1,Q3)表示。结果共纳入分析13505例初治患者,6390例经治患者。HBsAg<100、<500、<1500 IU/mL的初治患者比例为10.51%、28.47%、46.85%,对应经治患者比例为12.88%、29.84%、52.07%。HBsAg水平≥1500、≥3000、≥8000 IU/mL的初治患者比例为53.15%、38.17%、15.62%,对应经治患者比例为47.93%、31.77%、10.39%。HBsAg水平随抗病毒治疗时间增加,呈现出逐渐降低的趋势。HBsAg<100 IU/mL的经治患者占比从治疗时长不足3年时的12.73%升高至治疗时长≥10年时的26.92%,而HBsAg水平≥3000 IU/mL或≥8000 IU/mL患者的比例分别从34.66%降低至23.08%、从12.19%降低5.77%。HBsAg<100、<500、<1500 IU/mL的患者比例随年龄增加而增加,而HBsAg≥1500、≥3000及≥8000 IU/mL患者的分布占比则依次降低。结论CR-HepB平台对明确我国NAs初治和经治CHB患者血清HBsAg水平情况提供了可靠依据。HBsAg分布情况提示,随抗病毒治疗时间延长,HBsAg水平具有逐渐降低的趋势。Objective To explore the distribution characteristics of HBsAg levels in treatmentnaïve and treatment-experienced patients with chronic hepatitis B(CHB)in China.Methods Data were obtained from the China Registry of Hepatitis B(CR-HepB)platform from the establishment of the platform to April 11,2024.Patients with CHB who were treatment-naïve and treatment-experienced with nucleos(t)ide analogs(NAs)were included.Relevant clinical data were collected.The distribution of hepatitis B surface antigen(HBsAg)status,as well as the levels in populations of different age groups after different antiviral treatment durations,were retrospectively analyzed.Normally and non-normally distributed measured data were represented by Mean±SD,and M(Q1,Q3).Results A total of 13505 treatment-naïve patients and 6390 treatment-experienced patients were included in the analysis.The proportions of treatment-naïve patients with HBsAg<100,<500,and<1500 IU/mL were 10.51%,28.47%,and 46.85%,and the corresponding proportions of treatment-experienced patients were 12.88%,29.84%,and 52.07%.The proportions of treatment-naïve patients with HBsAg levels≥1500,≥3000,and≥8000 IU/mL were 53.15%,38.17%,and 15.62%,and the corresponding proportions of treatment-experienced patients were 47.93%,31.77%,and 10.39%.HBsAg level showed a trend of gradual decrease with the increase of antiviral treatment time.The proportion of treatment-experienced patients with HBsAg<100 IU/mL increased from 12.73%when the treatment duration was less than three years to 26.92%when the treatment duration was≥10 years,while the proportion of patients with HBsAg levels≥3000 IU/mL or≥8000 IU/mL decreased from 34.66%to 23.08%and from 12.19%to 5.77%,respectively.The proportion of patients with HBsAg<100,<500,and<1500 IU/mL increased with age,while the proportion of patients with HBsAg≥1500,≥3000,and≥8000 IU/mL decreased sequentially.Conclusions The CR-HepB platform provides a basis for clarifying the serum HBsAg levels in treatment-naïve and treatment-experienced

关 键 词：慢性乙型肝炎 乙型肝炎表面抗原 流行病学 初治 经治 

分 类 号：R512.62[医药卫生—内科学]