AIM:To evaluate the durability in hepatitis B e antigen (HBeAg) positive chronic hepatitis B patients who discontinued antiviral treatment. METHODS:A total of 48 HBeAg positive chronic hepatitis B patients who were ad...AIM:To evaluate the durability in hepatitis B e antigen (HBeAg) positive chronic hepatitis B patients who discontinued antiviral treatment. METHODS:A total of 48 HBeAg positive chronic hepatitis B patients who were administered nucleoside analogues and maintained virological response for ≥ 6 mo [hepatitis B virus (HBV) DNA < 300 copies/mL and HBeAg seroconversion] before cessation of treatment were enrolled between February 2007 and January 2010. The criteria for the cessation of the antiviral treatment were defined as follows:(1) achievement of virological response; and (2) duration of consolidation therapy (≥ 6 mo). After treatment cessation, the patients were followed up at 3-6 mo intervals. The primary endpoint was serologic and virologic recurrence rates after withdrawal of antiviral treatment. Serologic recurrence was defined as reappearance of HBeAg positivity after HBeAg seroconversion. Virologic recurrence was defined as an increase in HBV-DNA level > 104 copies/mL after HBeAg seroconversion with previously undetectable HBV-DNA level. RESULTS:During the median follow-up period of 18.2 mo (range:5.1-47.5 mo) after cessation of antiviral treatment, the cumulative serological recurrence rate was 15 % at 12 mo. The median duration between the cessation of antiviral treatment and serologic recurrence was 7.2 mo (range:1.2-10.9 mo). Of the 48 patients with HBeAg positive chronic hepatitis, 20 (41.6%) showed virological recurrence. The cumulative virologic recurrence rates at 12 mo after discontinuing the antiviral agent were 41%. The median duration between off-treatment and virologic recurrence was 7.6 mo (range:4.3-27.1 mo). The mean age of the virological recurrence group was older than that of the non-recurrence group (46.7 ± 12.1 years vs 38.8 ± 12.7 years, respectively; P = 0.022). Age (> 40 years) and the duration of consolidation treatment (≥ 15 mo) were significant predictive factors for offtreatment durability in the multivariate analysis [P = 0.049, relative risk (RR) 0.31, 95% CI (0.096-0.998) and P = 0.005, RR 11.29, 95% CI (2.054-65.12), respectively]. Patients with age (≤ 40 years) who received consolidation treatment (≥ 15 mo) significantly showed durability in HBeAg positive chronic hepatitis B patients (P = 0.014). These results suggest that additional treatment for more than 15 mo after HBeAg seroconversion in patients who are ≤ 40 years old may be beneficial in providing a sustained virological response. CONCLUSION:Our data suggest that HBeAg seroconversion is an imperfect end point in antiviral treatment. Long-term consolidation treatment (≥ 15 mo) in younger patients is important for producing better prognosis in HBeAg positive chronic hepatitis B.展开更多
探究喹硫平联合丙戊酸镁缓释片治疗双相情感障碍的效果。方法 随机抽取我院于2021年4月~2023年4月接诊的90例患者作为研究对象。应用随机抽签法均分为联合治疗组及基础组(n=45)。基础组行丙戊酸镁缓释片治疗,联合治疗组加用喹硫平治疗...探究喹硫平联合丙戊酸镁缓释片治疗双相情感障碍的效果。方法 随机抽取我院于2021年4月~2023年4月接诊的90例患者作为研究对象。应用随机抽签法均分为联合治疗组及基础组(n=45)。基础组行丙戊酸镁缓释片治疗,联合治疗组加用喹硫平治疗。比较相关指标。结果 联合治疗组认知功能中长时记忆(87.74±2.54 vs 84.58±2.63)分、短时记忆(88.55±2.64 vs 85.52±2.88)分、即刻记忆(88.39±2.73 vs 85.41±2.65)分、记忆商数(87.58±2.47 vs 84.61±2.56)分、语言智商(88.47±2.45 vs 85.62±2.38)分、操作智商(86.63±2.52 vs 83.47±2.66)分及智商(87.63±2.25 vs 84.74±2.37)分评分均高于基础组,组间数据比较存在统计学差异(P<0.05);联合治疗组临床症状评分(49.51±2.82 vs 53.69±2.77)分低于基础组,组间数据比较存在统计学差异(P<0.05);联合治疗组炎性因子水平中IL-4(2545.61±281.96 vs 3145.69±352.77)ng/ml、IL-1(998.84±207.35 vs 1836.65±311.54)ng/ml及TNF-(130.47±9.32 vs 151.83±11.37)pg/L水平均低于基础组,组间数据比较存在统计学差异(P<0.05);两组不良反应对比(13.33 vs 15.56)%无差异(P>0.05)。结论 喹硫平联合丙戊酸镁缓释片可以改善双相情感障碍患者的认知功能、临床症状,降低炎性因子水平,且无严重不良反应发生。展开更多
文摘AIM:To evaluate the durability in hepatitis B e antigen (HBeAg) positive chronic hepatitis B patients who discontinued antiviral treatment. METHODS:A total of 48 HBeAg positive chronic hepatitis B patients who were administered nucleoside analogues and maintained virological response for ≥ 6 mo [hepatitis B virus (HBV) DNA < 300 copies/mL and HBeAg seroconversion] before cessation of treatment were enrolled between February 2007 and January 2010. The criteria for the cessation of the antiviral treatment were defined as follows:(1) achievement of virological response; and (2) duration of consolidation therapy (≥ 6 mo). After treatment cessation, the patients were followed up at 3-6 mo intervals. The primary endpoint was serologic and virologic recurrence rates after withdrawal of antiviral treatment. Serologic recurrence was defined as reappearance of HBeAg positivity after HBeAg seroconversion. Virologic recurrence was defined as an increase in HBV-DNA level > 104 copies/mL after HBeAg seroconversion with previously undetectable HBV-DNA level. RESULTS:During the median follow-up period of 18.2 mo (range:5.1-47.5 mo) after cessation of antiviral treatment, the cumulative serological recurrence rate was 15 % at 12 mo. The median duration between the cessation of antiviral treatment and serologic recurrence was 7.2 mo (range:1.2-10.9 mo). Of the 48 patients with HBeAg positive chronic hepatitis, 20 (41.6%) showed virological recurrence. The cumulative virologic recurrence rates at 12 mo after discontinuing the antiviral agent were 41%. The median duration between off-treatment and virologic recurrence was 7.6 mo (range:4.3-27.1 mo). The mean age of the virological recurrence group was older than that of the non-recurrence group (46.7 ± 12.1 years vs 38.8 ± 12.7 years, respectively; P = 0.022). Age (> 40 years) and the duration of consolidation treatment (≥ 15 mo) were significant predictive factors for offtreatment durability in the multivariate analysis [P = 0.049, relative risk (RR) 0.31, 95% CI (0.096-0.998) and P = 0.005, RR 11.29, 95% CI (2.054-65.12), respectively]. Patients with age (≤ 40 years) who received consolidation treatment (≥ 15 mo) significantly showed durability in HBeAg positive chronic hepatitis B patients (P = 0.014). These results suggest that additional treatment for more than 15 mo after HBeAg seroconversion in patients who are ≤ 40 years old may be beneficial in providing a sustained virological response. CONCLUSION:Our data suggest that HBeAg seroconversion is an imperfect end point in antiviral treatment. Long-term consolidation treatment (≥ 15 mo) in younger patients is important for producing better prognosis in HBeAg positive chronic hepatitis B.
文摘探究喹硫平联合丙戊酸镁缓释片治疗双相情感障碍的效果。方法 随机抽取我院于2021年4月~2023年4月接诊的90例患者作为研究对象。应用随机抽签法均分为联合治疗组及基础组(n=45)。基础组行丙戊酸镁缓释片治疗,联合治疗组加用喹硫平治疗。比较相关指标。结果 联合治疗组认知功能中长时记忆(87.74±2.54 vs 84.58±2.63)分、短时记忆(88.55±2.64 vs 85.52±2.88)分、即刻记忆(88.39±2.73 vs 85.41±2.65)分、记忆商数(87.58±2.47 vs 84.61±2.56)分、语言智商(88.47±2.45 vs 85.62±2.38)分、操作智商(86.63±2.52 vs 83.47±2.66)分及智商(87.63±2.25 vs 84.74±2.37)分评分均高于基础组,组间数据比较存在统计学差异(P<0.05);联合治疗组临床症状评分(49.51±2.82 vs 53.69±2.77)分低于基础组,组间数据比较存在统计学差异(P<0.05);联合治疗组炎性因子水平中IL-4(2545.61±281.96 vs 3145.69±352.77)ng/ml、IL-1(998.84±207.35 vs 1836.65±311.54)ng/ml及TNF-(130.47±9.32 vs 151.83±11.37)pg/L水平均低于基础组,组间数据比较存在统计学差异(P<0.05);两组不良反应对比(13.33 vs 15.56)%无差异(P>0.05)。结论 喹硫平联合丙戊酸镁缓释片可以改善双相情感障碍患者的认知功能、临床症状,降低炎性因子水平,且无严重不良反应发生。
