不同e抗原水平检测方法对抗HBV治疗疗效评价结果的影响

Effects of Different Serum HBeAg Detection Methods on Therapy Effect Assessment of Anti-HBV Treatment

目的 :分析血清e抗原水平不同监测方法可能对抗HBV治疗中疗效评价和追踪期复发率评价的影响。方法 :对 69例α干扰素 (IFN)或拉米夫定 (LAM )抗HBV治疗评价为“完全应答”的慢性乙型肝炎患者追踪观察 ,比较 3 1例以ELISA法监测血清e抗原水平变化的患者和 3 8例应用时间分辨免疫荧光法的患者完全停药后的复发率 ,同时进行性别比、平均年龄、开始治疗时的ALT和HBVDNA水平及治疗方案的可比性分析。结果 :两组患者上述因素具有可比性 ,以ELISA法检测血清e抗原者追踪期复发率为 3 2 3 % ,应用时间分辨免疫荧光法者为 10 .5 % ,两者有统计学差异 (χ2 =4 .985 ,P =0 .0 2 6)。结论 :抗HBV治疗的疗效评价 ,其结果的客观性可能受e抗原水平监测方法的影响。推测时间分辨免疫荧光法有助于提高疗效评价的客观性 ,避免误判 ,从而指导合理用药 ,减少复发。

Objective:To analyze the effects of different serum HBeAg detction methods on the therapy effect assessment of anti HBV treatment and on follow up recurrence rates.Methods:In a follow up study of 69 chronic hepatitis B patients who were justified as “complete responsive” to α Interferon or Lamivudine in anti HBV therapy,after withdrawal of medicine,serum HBeAg from 31 patients was detected with ELISA and 38 with time resolved fluoroimmunoassay.Recurrence rates between two groups were compared.Comparability was analyzed in gender ratio,average age,ALT and HBV DNA level before therapy and in treatment modality.Results:Above factors were comparable between two groups.The recurrence rates of 31 patients with ELISA for detection of serum HBeAg and 38 with time resolved fluoroimmunoassay was 32 3% and 10 5% respectively,which was significantly different( χ 2 =4 985, P =0 026).Conclusion:The objectiveness of evaluation of therapy effects of anti HBV treatment may be affected by HBeAg detection methods.It was suggested that time resolved fluoroimmunoassay might help to improve the objectiveness of therapy effect evaluation,avoid misjudgement, guide the proper use of medicine and reduce recurrence.