定量检测HBsAg和HBeAg在干扰素治疗HBeAg阳性慢性乙肝疗效中的预测价值

Prediction Value of HBsAg and HBeAg in the Therapeutic Effect of Interferon on HBeAg Positive Chronic Hepatitis B

【目的】探讨定量检测血清乙肝表面抗原（HBsAg）和乙型肝炎病毒e抗原（HBeAg）水平的动态变化在预测干扰素治疗HBeAg阳性慢性乙肝疗效中的价值。【方法】回顾性分析2011-2014年在上海市公共卫生临床中心接受聚乙二醇干扰素a-2a（PEG-IFNa-2a）治疗的47例慢性乙型肝炎患者的临床资料。治疗48～72周，每周一次，每次180pg，治疗结束后随访24周，根据持续病毒学应答（SVR）标准将患者分为SVR组和非SVR组。治疗前、治疗12周、治疗24周分别定量检测血清HBsAg和HBeAg水平，观察两组患者相关指标的动态变化。【结果】治疗第12周及随访24周，SVR组患者血清HBeAg水平均显著低于非SVR组，差异具有统计学意义（P〈0．05）；随访第24周SVR组患者血清HBsAg水平显著低于非SVR组，差异具有统计学意义（P〈0．05）。SVR组患者血清HBeAg、HBsAg水平下降幅度均大于非SVR组患者，差异具有统计学意义（P〈0．05）。ROC曲线分析发现24周时HBeAg水平有最佳的预测价值。【结论]HBsAg和HBeAg水平均对干扰素疗效有较好的预测价值，但HBeAg优于HBsAg。

[Objective]To investigate the dynamic changes of serum hepatitis B surface antigen （HBsAg） and hepatitis B virus e antigen （HBeAg） levels for the prediction of the therapeutic effect of interferon on HBeAg positive chronic hepatitis B. [Methods]The clinical data of 47 patients with chronic hepatitis B treated by（PEG-IFNa-2a in the Public Health Center of Shanghai were analyzed retrospectively. Treatment ：48-72 weeks, onee/week,180μg,24 weeks of follow-up after treatment. According to the criteria for sustained viral response （SVR）, patients were divided into the SVR group and the non SVR group. The levels of serum HBsAg and HBeAg of pre-treatment, 12 weeks and 24 weeks post treatment were detected respectively, and the dynamic changes of the related indexes of the two groups were observed. [Results]In the twelfth week of treatment and 24-week follow-up , the level of serum HBeAg in patients of the SVR group was significantly lower than that in the non SVR group, the difference was statistically significant（ P〈0.05） In twenty-fourth week of follow-up, the level of serum HBsAg of the SVR group was significantly lower than that in the non SVR group, the difference was statistically significant（ P 〈0.05）. The decreasing rate of serum HBeAg and HBsAg levels in the SVR group were significantly higher than those in the non SVR group, the difference was statistically significant （ P 〈0.05）. Roe curve analysis showed that the HBeAg level had the best predictive value at 24th week.[Conclusion] Both HBsAg and HBeAg have good predictive value on the efficacy of interferon, while HBeAg is better than HBsAg.