替比夫定治疗HBeAg阳性慢性乙型肝炎患者HBeAg血清学转换的预测因素分析

Analysis on the factors influencing HBeAg seroconversion in chronic hepatitis B patients treated with telbivudine

目的:探讨替比夫定治疗HBeAg阳性慢性乙型肝炎(CHB)患者HBeAg血清学转换的预测因素。方法:选取2011年9月至2015年8月广西医科大学第一附属医院感染科门诊治疗的77例HBeAg阳性CHB患者,均采用替比夫定口服治疗。根据随访终点时是否出现HBeAg血清学转换分为转换组(34例)和未转换组(43例)。比较两组患者相关临床指标的差异,并采用多因素Logistic回归分析法分析影响HBeAg血清学转换的因素。结果:两组年龄、性别、基线HBV DNA、基线总胆红素(TBIL)、白蛋白(ALB)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆汁酸(TBA)、碱性磷酸酶(ALP)、前白蛋白(PALB)、胆碱酯酶(CHE)等指标比较差异均无统计学意义(均P>0.05),而两组基线球蛋白(GLO)水平比较差异具有统计学意义(P<0.05);多因素Logistic回归分析结果显示:基线低GLO水平为HBeAg血清学转换的独立预测因素(P<0.05)。结论:基线低GLO水平可能为替比夫定治疗HBeAg阳性CHB患者HBeAg血清学转换的独立预测因素。

Objective： To investigate the factors for HBeAg seroconversion in chronic hepatitis B （CHB）patients with telbivudine treatment. Methods： 77 HBeAg positive CHB patients treated with telbivudine in our hospital from September 2011 to August 2015 were selected. At the end of the follow-up, 34 patients remained HBeAg positive （non-seroconversion group） and 43 patients achieved HBeAg seroconversion （seroconversion group）. The factors influencing HBeAg seroconversion were analyzed by univariate analysis and multiple logistic regression analysis. Results： There were no significant differences in the age, gender, baseline HBV DNA, baseline total bilirubin （TBIL） , albumin （ALB） , aspartate transaminase （AST） , alanine aminotransferase （ALT）, total bile acid （TBA）, alkaline phosphatase （ALP） , prealbumin （PALB） and cholinesterase （CHE） levels between the two groups （P〉0. 05）. A significant difference was found in baseline globulin （GLO） level between the two groups （P〈0.05）. Mulvariate logistic regression analysis showed that the baseline GLO was the factor influencing HBeAg seroconversion in CHB patients after telbivudine treatment. Conclusion： Baseline GLO may be the influencing factor for HBeAg seroconversion in HBeAg positive CHB patients with telbivudine treatment.