HBsAg定量与HBeAg阳性慢性乙型肝炎病人抗病毒治疗效果的关系

CORRELATION BETWEEN QUANTITATIVE ASSAY OF HBsAg AND EFFICACY OF HBeAg-POSITIVE CHRONIC HEPATITIS B TREATED WITH ANTIVIRAL THERAPY

目的分析HBsAg定量的动态变化和HBeAg血清转换率的关系,探讨HBsAg定量对干扰素治疗HBeAg阳性慢性乙型肝炎病人效果的预测价值。方法 HBeAg阳性慢性乙型肝炎病人87例,根据病人的意愿分为干扰素组(49例)和拉米夫定组(38例),分别应用干扰素和拉米夫定治疗48周。分别于治疗前,治疗12、24、36、48周检测血清HBsAg、HBeAg和HBeAb定量水平,分析治疗12周时HBsAg水平的下降幅度与治疗48周时HBeAb/HBeAg比值的相关性。结果拉米夫定组HBsAg定量水平在治疗过程中变化不明显,干扰素组HBsAg定量水平在治疗过程中进行性下降(F=15.112,P<0.01)。拉米夫定组和干扰素组比较,治疗前HBsAg定量水平差异无显著性(P>0.05);治疗12、24、36、48周干扰素组HBsAg定量水平低于拉米夫定组,差异有显著性(t=2.292～9.664,P<0.05)。拉米夫定组治疗12周时HBsAg水平下降幅度与48周时HBeAb/HBeAg比值无相关性(r=0.385,P>0.05),而干扰素组治疗12周时HBsAg水平下降幅度与48周时HBeAb/HBeAg比值呈正相关(r=0.322,P<0.05)。结论治疗12周时血清HBsAg水平下降幅度对于干扰素治疗HBeAg阳性慢性乙型肝炎效果有一定的预测价值。

Objective To analyze the relationship between dynamic changes of quantitative HBsAg and HBeAg serocon- version rate, and assess the value of HBsAg quantitation in predicting the efficacy of interferon in the treatment of HBeAg-positive chronic hepatitis B （HPCHB）. Methods Eighty-seven patients with HPCHB were divided into interferon group （49 cases） and lamivudine group （38 cases） keeping with their wish. The patients were treated with interferon or lamivudine, accordingly, for 48 weeks. Serum HBsAg, HBeAg, and HBeAb quantitation were detected before and 12, 24, 36 and 48 weeks after treatment. At week 12, the correlation of decreased range of HBsAg with the ratio of HBeAb/HBeAg at week 48 was analyzed. Results Du- ring the process of therapy, the changes of HBsAg quantitation in lamivudine group were not significant, hut that in interferon group was progressively decline （F = 15.112, P 〈0.01）. Before therapy, the difference of HBsAg quantitation between the two groups was not significant; at weeks 12, 24, 36 and 48, the levels of HBsAg in interferon group were lower than that in lamivudine group, the difference being statistically significant （t = 2. 292-9. 664, P 〈0.05）. At week 12, the decline of HBsAg in lamivudine group was not correlated with the ratio of HBeAb/HBeAg at week 48 （r=0. 385 ,P〉0. 05）, but that was positively correlated in interferon group （r=0. 322,P〈0.05）. Conclusion The decline range of serum HBsAg quantitation at week 12 has some pre- dictive value for HPCHB treated with interferon.