慢性乙型肝炎患者e抗原消失的临床特点

Clinical Features of e Antigen Disappearance in Patients with Chronic Hepatitis B

目的探讨慢性乙型肝炎患者使用核苷类似物抗病毒治疗e抗原消失后HBV DNA、转氨酶等指标的变化特点。方法选取2014年12月～2017年6月四川省中西医结合医院门诊109例慢性乙型肝炎患者,在服用核苷类似物抗病毒的治疗过程中出现e抗原消失,检测并分析治疗前后e抗原抗体系统的变化与HBV DNA关系、ALT异常率、血清HBV DNA水平与HBeAg相关性分析。结果 HBV DNA转小二阳时及转后半年、1年与治疗前比较,差异有统计学意义(P<0.05);转小二阳后半年与刚转小二阳时比较,差异有统计学意义(P<0.05);转小二阳后1年与刚转小二阳时比较,差异无统计学意义(P>0.05)。治疗前和治疗后的ALT异常率比较,差异有统计学意义(P<0.05),转小二阳时以及转后的半年、1年ALT异常率相比,差异均无统计学意义(P>0.05)。血清HBV DNA水平与HBeAg呈正相关关系(r=0.879,P<0.001)。结论大三阳患者在治疗过程中,发生e抗原的消失的状态是不稳定的,仍然可能会出现病毒DNA的复制,转氨酶的异常。

Objective To investigate the changes of HBV DNA and transaminase in patients with chronic hepatitis B after anti-viral treatment with nucleoside analogue antiviral therapy. Methods A total of 109 patients with chronic hepatitis B from the outpatient department of Sichuan Provincial Hospital of Integrated Traditional Chinese and Western Medicine from December 2014 to June 2017 were selected. The e antigen disappeared during the antiviral treatment of nucleoside analogues. The e antigen was detected and analyzed before and after treatment. Changes in antibody system and HBV DNA, ALT abnormalities, serum HBV DNA levels and HBeAg correlation analysis.Results There was a significant difference between the two groups when HBV DNA was converted to primary two-positive, half a year after turning and one year before treatment (P<0.05), and there was a significant difference between the two groups in the second half-year after turning to primary two-positive (P<0.05), there was no significant difference between the two groups in the second a year after turning to primary two-positive (P>0.05).There was a significant difference in the abnormal rate of ALT between before and after treatment (P<0.05). There was no significant difference in the abnormal rate of ALT at the time of conversion to primary two positive, half a year and one year after the treatment (P>0.05).There was a positive correlation between serum HBV DNA level and HBeAg(r=0.879, P<0.001). Conclusion In the treatment of Dasanyang patients, the state of disappearance of e antigen is unstable, and replication of viral DNA and abnormalities of transaminase may still occur.