HBsAg定量预测干扰素治疗e抗原阳性慢性乙型肝炎的远期疗效

The long-term efficacy of prediction analysis with quantitative HBsAg in e antigen positive chronic hepatitis B administrated with IFNα-2b

目的观察血清中的HBsAg水平与e抗原的血清转换率的关系,预测干扰素的远期疗效。方法 86例e抗原阳性慢性乙型肝炎（CHB）患者按照治疗前HBsAg定量〈100、100~200、〉200 ng/L分为3组,均给予干扰素抗病毒治疗12个月。对照组18例,未予干扰素治疗。在不同治疗时间分别检测血清ALT、HBV DNA、HBsAg、HBeAg和HBcAb,并计算治疗3个月时HBsAg抑制率,按照其≥50%和〈50%分为2组,观察治疗终点时e抗原的血清转换率、HBsAg阴转率和HBV DNA阴转率。结果治疗终点时,三个层次的干扰素治疗组和对照组e抗原的血清转换率分别为58.5%、37.3%、20.0%和5.6%,HBsAg的阴转率分别为54.5%、15.6%、6.7%和0,HBVDNA的血清阴转率分别为70.8%、34.4%、23.3%和0。e抗原的血清转换率与HBsAg初始水平和治疗3个月时下降幅度有相关性。结论 HBsAg初始水平或治疗3个月后下降幅度是获得较高e抗原的血清转换率较好的预测指标,有助于指导临床用药。

Objective To explore the relation between quantities of HBsAg and frequency of seroconversion of HBeAg/HBeAb,as well as to predict the prostecdtive efficacy of treating chronic hepatitis B（CHB） with IFN-α2b.Methods Eighty-six HBeAg positive CHB patients administrated for IFN-α2b were randomly divided into 3 treatment groups according to the level of HBsAg.In control group 18 patients were treated by using routine drugs.Alanine aminotransferase,HBV DNA,quantities of HBsAg and HBeAg in serum were detected by using ELISA.The inhibition rate of HBsAg was calculated for three months.Patients in treatment group were divided into two groups according to the inhibition rate.The e antigen seroconversion,HBsAg negative conversion rate and HBV DNA negative rate were observed at the end of treatment.Result When the original levels of HBsAg in treatment group were 100 ng/L,100-200 ng/L and 200 ng/L,we found that seroconversion rate of HBeAg/HBeAb was 58.3%,37.5% and 20.0%,negative conversion rate of HBsAg was 54.2%,15.6% and 6.7%,negative conversion rate of HBVDNA was 70.8%,34.4%,23.3% respectively.All above rates were higher than that of control group significantly（P〈0.01）.There was a correlation between the original level or the decreasing amplitude of HBsAg and rate of seroconversion of HBeAg/HBeAb.Conclusion Incipient level and decreasing amplitude of HBsAg are index of prostecdtive efficacy after treating CHB with IFNα-2b,which can contribute to conduct clinical medication.