血清壳多糖酶3样蛋白1联合异常凝血酶原在慢性乙肝患者核苷类似物治疗中的价值研究

Study on the Value of Serum CHI3L1 Combined with Abnormal Prothrombin in Nucleoside Analogues Treatment of Hepatitis B

目的探究血清壳多糖酶3样蛋白1(CHI3L1)联合异常凝血酶原(PIVKA-Ⅱ)在慢性乙肝患者核苷类似物治疗中的应用价值。方法选择2020年3~9月在广东省东莞市人民医院就诊且接受核苷类似物治疗的90例慢性乙肝患者进行研究,在患者治疗前、治疗12周、24周、36周后进行乙肝病毒载量(HBV-DNA)、血清CHI3L1、PIVKA-Ⅱ水平检测。并在治疗36周后评估患者的治疗效果根据其疗效分为有效组和无效组,比较两组的血清HBV-DNA、CHI3L1、PIVKA-Ⅱ水平差异。结果治疗12周、24周、36周后,90例患者的血清HBV-DNA、CHI3L1、PIVKA-Ⅱ水平逐渐降低,差异有统计学意义(P<0.05)。治疗36周后,治疗有效组患者的血清HBV-DNA、CHI3L1、PIVKA-Ⅱ水平显著低于治疗无效组(P<0.05)。经Pearson相关系数分析,血清HBV-DNA与CHI3L1、PIVKA-Ⅱ水平呈正相关(P<0.05)。结论动态检测血清CHI3L1、PIVKA-Ⅱ水平在慢性乙肝患者核苷类似物治疗中发挥着重要的作用,其不仅能够评估慢性乙肝患者的病情进展,还可为临床监测抗病毒疗效提供参考。

Objective To explore the application value of serum chitinase 3 like protein 1(CHI3L1)combined with abnormal prothrombin(PIVKA-II)in nucleoside analoguestreatment of hepatitis B.Methods 90 patients with chronic hepatitis B treated in our hospital from March 2020 to September 2020 and receiving nucleoside analogues treatment were selected.Hepatitis B virus load(HBV-DNA),serum CHI3L1 and PIVKA-II levels were detected before treatment,12 weeks,24 weeks and 36 weeks after treatment.At the same time,the therapeutic effect was evaluated after 36 weeks of treatment.According to the curative effect,the patients were divided into effective group and ineffective group.The differences of HBV-DNA,serum CHI3L1 and PIVKA-Ⅱlevels between the two groups were compared.Results After 12 weeks,24 weeks and 36weeks of treatment,the levels of HBV-DNA,serum CHI3L1 and PIVKA-Ⅱ in 90 patients gradually decreased,and the difference was statistically significant(P<0.05).The levels of HBV-DNA,serum CHI3L1 and PIVKA-Ⅱ in the effective group were significantly lower than the ineffective group(P<0.05).Pearson correlation coefficient analysis showed that HBV-DNA was positively correlated with serum CHI3L1 and PIVKA-Ⅱ levels(P<0.05).Conclusion Dynamic detection of serum CHI3L1 and PIVKA-Ⅱ levels plays an important role in nucleoside analogues treatment of chronic hepatitis B patients.It can not only assess the progress of patients with chronic hepatitis B,but also provide a reference for clinical monitoring of antiviral efficacy.