摘要
目的研究HBsAg、HBeAg和HBV DNA水平对HBeAg阳性慢性乙型肝炎病人恩替卡韦治疗效果的评估价值。方法选择应用恩替卡韦治疗≥3年的HBeAg阳性慢性乙型肝炎病人164例,对其基线时和治疗过程中的血清HBsAg、HBeAg和HBV DNA水平进行观察。结果治疗3年后87.8%的病人发生了病毒学应答,34.1%的病人HBeAg发生了血清学转换。基线时的HBsAg和HBeAg对病毒学应答有评估价值(t=3.17、2.61,P<0.05)。与其余指标比较,治疗过程中HBV DNA下降水平对评估病毒学应答、HBeAg滴度对评估血清学转换有更高评估价值。最佳病毒学应答评估时间为治疗6个月,此时HBV DNA绝对值切点为2.40log10kU/L;最佳血清学转换评估时间为治疗12个月,此时HBeAg滴度评估切点为0.59log10kU/L。结论基线时HBsAg和HBeAg滴度均能评估恩替卡韦的远期治疗效果,而治疗过程中HBV DNA动态变化的评估效果更好。
Objective To study the dynamic changes of HBsAg,HBeAg and HBV DNA in evaluation of clinical efficacy of entecavir therapy for chronic hepatitis B patients with positive HBeAg. Methods A total of 164 chronic hepatitis B patients with HBeAg positive received entecavir therapy for≥3years were selected in this study.The serum levels of HBsAg,HBeAg and HBV DNA at baseline and during the treatment were observed. Results After three years of entecavir therapy,virological response was achieved in 87.8% of the patients,and 34.1% of the patients got HBeAg seroconversion.Baseline HBsAg and HBeAg had evaluation value in virologic response（t=3.17,2.61;P〈0.05）.Compared with other indicators,the decrease in absolute level of HBV DNA during treatment for assessment of virological response,and HBeAg titer for seroconversion prediction had a higher evaluation value.The best time for evaluation of virological response was in six months of treatment,at this point,the absolute value of the tangent point of HBV DNA level was at 2.40log10kU/L The best time for assessment of seroconversion was at 12-month treatment,at this point,the tangent point of HBeAg titer was 0.59log10kU/L. Conclusion Both HBsAg and HBeAg level at baseline can predict long-term therapeutic effect of entecavir in the therapy of chronic hepatitis B patients with positive HBeAg,the dynamic changes of HBV DNA in the course of treatment are more helpful for the prediction.
出处
《青岛大学医学院学报》
CAS
2016年第4期442-445,共4页
Acta Academiae Medicinae Qingdao Universitatis
基金
青岛市卫生局科研课题(20120468)
