Peg IFN-α治疗HBeAg阳性CHB患者过程中血清HBV RNA水平的变化及临床意义

Changes and clinical value of serum HBV RNA level on HBeAg positive CHB patients treated with the treatment of Peg IFN-α

目的:探讨Peg IFN-α治疗HBeAg阳性CHB患者过程中血清HBV RNA水平的变化及意义。方法:选择接受Peg IFN-α治疗HBeAg阳性CHB患者34例为研究对象。分别于治疗前及治疗12、24、52周检测患者血清HBV RNA、HBV DNA、ALT水平,并分析Peg IFN-α抗病毒治疗过程中血清HBV RNA水平与ALT、HBeAg状态及应答状态的相关性。结果:所有患者治疗12、24、52周时ALT水平均较治疗前明显降低,治疗24、52周时ALT水平较治疗12周时降低,治疗52周时ALT水平较治疗24周时降低,差异均具有统计学意义(P<0.05)。治疗12、24、52周时,ALT复常率分别为41.18%(14/34)、55.88%(19/34)、76.47%(26/34),HBeAg阴转率分别为26.47%(9/34)、29.41%(10/34)、47.06%(16/34),HBV DNA阴转率分别为38.23%(13/34)、50.00%(17/34)、61.76%(21/34)。治疗12、24、52周时患者血清HBV RNA水平均较治疗前降低,差异均具有统计学意义(P<0.05)。治疗12、24、52周时,ALT水平复常患者血清HBV RNA水平均低于ALT水平未复常患者,HBeAg阴转患者血清HBV RNA水平均低于未阴转患者,完全应答患者血清HBV RNA水平均低于非完全应答患者,差异均具有统计学意义(P<0.05)。Person相关性分析结果显示,Peg IFN-α抗病毒治疗过程中患者血清HBV RNA水平与HBV DNA水平呈正相关(r=0.408,P=0.009)。结论:Peg IFN-α治疗过程中患者血清HBV RNA水平总体呈下降趋势,与HBV DNA水平呈正相关,有望作为评估抗HBV感染治疗疗效的一个辅助指标,具有一定的临床价值。

Objective: To explore changes and clinical value of serum HBV RNA level on HBeAg positive CHB patients treated with the treatment of Peg IFN-α.Methods: Totally 34 cases of patients with HBeAg positive CHB who received Peg IFN-αtreatment in our hospital from February 2014 to October 2015 were selected.Serum HBV RNA,HBV DNA,and ALT levels in patients were detected before treatment,and at treatment of 12 weeks,24 weeks,and 52 weeks,respectively.The relationship between serum HBV RNA levels and ALT,HBeAg status and response status during Peg IFN-αantiviral treatment was analyzed.Results: The serum ALT level in patients at 12,24 and 52 weeks after treatment was significantly lower than that in patients before treatment,the serum ALT level in patients at 24 and 52 weeks after treatment was significantly lower than that in patients at 12 weeks after treatment,the serum ALT level in patients at 52 weeks after treatment was significantly lower than that in patients at 24 weeks after treatment,all above had statistical difference(P<0.05).At 12,24 and 52 weeks after treatment,ALT recurrence rate was 41.18%(14/34),55.88%(19/34),and 76.47%(26/34),respectively;the negative conversion rate of HBeAg was 26.47%(9/34),29.41%(10/34)and 47.06%(16/34),respectively;the negative conversion rate of HBV DNA was 38.23%(13/34),50.00%(17/34),and 61.76%(21/34),respectively.The serum HBV RNA level in patients at 12,24 and 52 weeks after treatment was significantly lower than that in patients before treatment,and all differences are statistical significant(P<0.05).At 12,24 and 52 weeks after treatment,the serum HBV RNA level in patients with recurrent ALT level was significantly lower than that in patients without recurrent ALT level,the serum HBV RNA level in patients with negative conversion of HBeAg was significantly lower than that in patients without negative conversion of HBeAg,the serum HBV RNA level in patients with complete response was significantly lower than that in patients without complete response,all above had statistical difference(P<0.05).The results of Person correlation analysis showed that the serum HBV RNA level was significantly positively correlated with HBV DNA level(r=0.408,P=0.009).Conclusion:During the treatment of Peg IFN-α,the serum HBV RNA level showed an overall downward trend,which was significantly positively correlated with the HBV DNA level.It is expected to serve as an auxiliary indicator for evaluating the efficacy of anti-HBV infection treatment,and has certain clinical value.