拉米夫定治疗慢性乙型肝炎患者定量检测HBeAg的意义

Detection of serum hepatitis B virus e antigen in patients with chronic hepatitis B receiving lamivudine therapy

目的探讨拉米夫定治疗的慢性乙型肝炎患者血清HBeAg和HBV DNA载量的变化规律。方法采用免疫化学发光和荧光定量聚合酶链反应技术分别检测了64例HBeAg阳性的慢性乙型肝炎患者在接受拉米夫定治疗过程中血清HBeAg和HBV DNA水平的变化。结果治疗12个月,HBV DNA完全转阴49例(76.6%),HBeAg转阴17例(26.6%),他们的HBV DNA和HbeAg水平呈同步下降趋势;11例治疗无效的患者血清HBV DNA和HBeAg水平也呈下降趋势,但始终未转阴;4例HBV DNA短暂转阴的患者,在治疗6个月后又转为阳性,HbeAg也未阴转。结论在拉米夫定抗病毒治疗过程中动态检测HBeAg水平可用于评估抗病毒的效果。

Objective To study the changes of serum hepatitis B virus e antigen and HBV DNA load in patients with hepatitis B treated with lamivudine. Methods Emzyme chemiluminescence immunoassay and realtime fluorescent quantitative PCR were performed in detecting the level of serum HBeAg and HBV DNA in 64 patients in 12 -month lamivudine therapy. Results HBV DNA turned negative in 49 （76.6%）out of the 64 patients,and HBeAg reduced to the level undetectable in 17 （26.6%）;11 patients were nonreponded to lamivudine treatment with their serum HbeAg and HBV DNA positive;Four patients had their HBV DNA transiently negative,but it turned to be positive again after 6 month. Conciusion Detecting serum HBeAg dynamically might be useful in evaluation of lamivadine therapeutic effect.