目的:系统分析双虎清肝颗粒对慢性乙型肝炎患者HBe-Ag及HBV-DNA阴转率的作用,为评价药物的作用以及临床运用提供科学的依据。方法:使用计算机搜索自成立到2017年9月中国期刊全文数据库、Wanfang数据库、VIP、CBM、Pubmed、Embase、Cochr...目的:系统分析双虎清肝颗粒对慢性乙型肝炎患者HBe-Ag及HBV-DNA阴转率的作用,为评价药物的作用以及临床运用提供科学的依据。方法:使用计算机搜索自成立到2017年9月中国期刊全文数据库、Wanfang数据库、VIP、CBM、Pubmed、Embase、Cochrane图书馆、Web of Science中关于双虎清肝颗粒治疗慢性乙型肝炎的随机对照试验,根据放入与清除的规定,提取研究结果进行分析,对放入的文献质量用Jadad量表进行评估,用Cochrane协作网提供的Rev Man5.3软件将随机对照试验结果进行Meta分析。结果:总共纳入4个研究,共552个受试对象,其中试验组319例,对照组233例。HBe-Ag阴转率OR=1.37,95%CI(0.93,2.00),差异没有统计学意义(P>0.05)。HBV-DNA转阴率OR=2.82,95%CI(1.82,4.36),差异有统计学意义(P<0.05)。结论:因为HBe-Ag、HBV-DNA是反应乙型肝炎病毒在体内复制的指标,所以双虎清肝颗粒抗病毒确实具有一定的疗效,但从目前的证据来看,疗效也没有达到我们的预期,可能和目前的证据质量偏低有关,将来需要多中心、大样本的临床研究等高质量的证据对双虎清肝颗粒的疗效进一步的验证。展开更多
AIM To investigate the characteristic features of hepatitis B surface antigen(HBs Ag) seroclearance among Korean hepatitis B virus(HBV) carriers.METHODS Carriers with HBs Ag seroclearance were selected by analyzing lo...AIM To investigate the characteristic features of hepatitis B surface antigen(HBs Ag) seroclearance among Korean hepatitis B virus(HBV) carriers.METHODS Carriers with HBs Ag seroclearance were selected by analyzing longitudinal data collected from 2003 to 2015. The period of time from enrollment to the negative conversion of HBs Ag(HBs Ag-NC) was compared by stratifying various factors, including age, sex, hepatitis B e antigen(HBe Ag), HBV DNA, sequential changes in the signal-to-cutoff ratio of HBs Ag(HBs Ag-SCR), as measured by qualitative HBs Ag assay, and chronic liver disease on ultrasonography(US-CLD). Quantification of HBV DNA and HBs Ag(HBs Ag-QNT) in the serum was performed by commercial assay.RESULTS Among the 1919 carriers, 90(4.7%) exhibited HBs AgNC at 6.2 ± 3.6 years after registration, with no differences observed among the different age groups. Among these carriers, the percentages of those with asymptomatic liver cirrhosis(LC) and hepatocellular carcinoma(HCC) at registration were 31% and 7.8%, respectively. The frequency of HBs Ag-NC significantly differed according to the HBV DNA titer and US-CLD. HBe Ag influenced HBs Ag-NC in the 40-50 and 50-60 year age groups. HBs Ag-SCR < 1000 was correlated with an HBs Ag-QNT < 200 IU/m L. A gradual decrease in the HBs Ag-SCR to < 1000 predicted HBs Ag-NC. Six patients developed HCC after registration, including two before and four after HBs Ag-NC. The rate at which the patients developed new HCC after HBs Ag seroclearance was 4.8%. LC with excessive drinking and vertical infection were found to be risk factors for HCC in the HBs Ag-NC group.CONCLUSION HCC surveillance should be continued after HBs Ag seroclearance. An HBs Ag-SCR < 1000 and its decrease in sequential testing are worth noting as predictive markers of HBs Ag loss.展开更多
目的:观察补肾解毒方治疗肾虚型乙型肝炎病毒e抗原(hepatitis Be antigen,HBe Ag)阳性慢性乙型肝炎病毒(hepatitis B virus,HBV)携带者的临床疗效。方法:将68例肾虚型乙型肝炎病毒e抗原(HBeAg)阳性的慢性HBV携带者,采用随机、双盲、安...目的:观察补肾解毒方治疗肾虚型乙型肝炎病毒e抗原(hepatitis Be antigen,HBe Ag)阳性慢性乙型肝炎病毒(hepatitis B virus,HBV)携带者的临床疗效。方法:将68例肾虚型乙型肝炎病毒e抗原(HBeAg)阳性的慢性HBV携带者,采用随机、双盲、安慰剂对照的临床研究方法,随机分为观察组和对照组,每组34例。观察组予补肾解毒方治疗,口服,1剂/d;对照组使用安慰剂治疗,疗程60周。观察其抗HBV-DNA疗效及对血清乙型肝炎病毒表面抗原(hepatitis B surface antigen,HBsAg)、HBeAg定量的影响。结果:60周后观察组HBe Ag转阴率、HBV-DNA阴转率均优于对照组,差异有统计学意义(P<0.05)。补肾解毒方治疗期间,未见明显不良反应发生。HBV-DNA和HBsAg定量观察组治疗前后比较,差异有统计学意义(P<0.05),治疗后2组比较差异有统计学意义(P<0.05)。结论:补肾解毒方治疗慢性HBV携带者的抗病毒疗效确切。展开更多
Objective To explore the predictive value of baseline HBs Ag level and early response for HBs Ag loss in patients with HBe Ag-positive chronic hepatitis B during pegylated interferon alpha-2a treatment. Methods A tota...Objective To explore the predictive value of baseline HBs Ag level and early response for HBs Ag loss in patients with HBe Ag-positive chronic hepatitis B during pegylated interferon alpha-2a treatment. Methods A total of 121 patients with HBe Ag-positive chronic hepatitis B who achieved HBs Ag loss were enrolled; all patients were treated with PEG-IFNα-2a 180 μg/week. Serum HBV DNA and serological indicators (HBs Ag, anti-HBs, HBe Ag, and anti-HBe) were determined before and every 3 months during treatment. Results The median treatment time for HBs Ag loss was 84 weeks (7-273 weeks), and 74.38% (90 cases) of the patients needed extended treatment (〉 48 weeks). The correlation between baseline HBs Ag levels and the treatment time of HBs Ag loss was significant (B = 14.465, t = 2.342, P = 0.021). Baseline HBs Ag levels together with the decline range of HBs Ag at 24 weeks significantly correlated with the treatment time of HBs Ag loss (B = 29.862, t = 4.890, P = 0.000 and B = 27.993, t = 27.993, P = 0.005). Conclusion Baseline HBs Ag levels and extended therapy are critical steps toward HBs Ag loss. Baseline HBs Ag levels together with early response determined the treatment time of HBs Ag loss in patients with HBe Ag-positive chronic hepatitis B during pegylated interferon alpha-2a treatment.展开更多
文摘目的:系统分析双虎清肝颗粒对慢性乙型肝炎患者HBe-Ag及HBV-DNA阴转率的作用,为评价药物的作用以及临床运用提供科学的依据。方法:使用计算机搜索自成立到2017年9月中国期刊全文数据库、Wanfang数据库、VIP、CBM、Pubmed、Embase、Cochrane图书馆、Web of Science中关于双虎清肝颗粒治疗慢性乙型肝炎的随机对照试验,根据放入与清除的规定,提取研究结果进行分析,对放入的文献质量用Jadad量表进行评估,用Cochrane协作网提供的Rev Man5.3软件将随机对照试验结果进行Meta分析。结果:总共纳入4个研究,共552个受试对象,其中试验组319例,对照组233例。HBe-Ag阴转率OR=1.37,95%CI(0.93,2.00),差异没有统计学意义(P>0.05)。HBV-DNA转阴率OR=2.82,95%CI(1.82,4.36),差异有统计学意义(P<0.05)。结论:因为HBe-Ag、HBV-DNA是反应乙型肝炎病毒在体内复制的指标,所以双虎清肝颗粒抗病毒确实具有一定的疗效,但从目前的证据来看,疗效也没有达到我们的预期,可能和目前的证据质量偏低有关,将来需要多中心、大样本的临床研究等高质量的证据对双虎清肝颗粒的疗效进一步的验证。
文摘AIM To investigate the characteristic features of hepatitis B surface antigen(HBs Ag) seroclearance among Korean hepatitis B virus(HBV) carriers.METHODS Carriers with HBs Ag seroclearance were selected by analyzing longitudinal data collected from 2003 to 2015. The period of time from enrollment to the negative conversion of HBs Ag(HBs Ag-NC) was compared by stratifying various factors, including age, sex, hepatitis B e antigen(HBe Ag), HBV DNA, sequential changes in the signal-to-cutoff ratio of HBs Ag(HBs Ag-SCR), as measured by qualitative HBs Ag assay, and chronic liver disease on ultrasonography(US-CLD). Quantification of HBV DNA and HBs Ag(HBs Ag-QNT) in the serum was performed by commercial assay.RESULTS Among the 1919 carriers, 90(4.7%) exhibited HBs AgNC at 6.2 ± 3.6 years after registration, with no differences observed among the different age groups. Among these carriers, the percentages of those with asymptomatic liver cirrhosis(LC) and hepatocellular carcinoma(HCC) at registration were 31% and 7.8%, respectively. The frequency of HBs Ag-NC significantly differed according to the HBV DNA titer and US-CLD. HBe Ag influenced HBs Ag-NC in the 40-50 and 50-60 year age groups. HBs Ag-SCR < 1000 was correlated with an HBs Ag-QNT < 200 IU/m L. A gradual decrease in the HBs Ag-SCR to < 1000 predicted HBs Ag-NC. Six patients developed HCC after registration, including two before and four after HBs Ag-NC. The rate at which the patients developed new HCC after HBs Ag seroclearance was 4.8%. LC with excessive drinking and vertical infection were found to be risk factors for HCC in the HBs Ag-NC group.CONCLUSION HCC surveillance should be continued after HBs Ag seroclearance. An HBs Ag-SCR < 1000 and its decrease in sequential testing are worth noting as predictive markers of HBs Ag loss.
文摘目的:观察补肾解毒方治疗肾虚型乙型肝炎病毒e抗原(hepatitis Be antigen,HBe Ag)阳性慢性乙型肝炎病毒(hepatitis B virus,HBV)携带者的临床疗效。方法:将68例肾虚型乙型肝炎病毒e抗原(HBeAg)阳性的慢性HBV携带者,采用随机、双盲、安慰剂对照的临床研究方法,随机分为观察组和对照组,每组34例。观察组予补肾解毒方治疗,口服,1剂/d;对照组使用安慰剂治疗,疗程60周。观察其抗HBV-DNA疗效及对血清乙型肝炎病毒表面抗原(hepatitis B surface antigen,HBsAg)、HBeAg定量的影响。结果:60周后观察组HBe Ag转阴率、HBV-DNA阴转率均优于对照组,差异有统计学意义(P<0.05)。补肾解毒方治疗期间,未见明显不良反应发生。HBV-DNA和HBsAg定量观察组治疗前后比较,差异有统计学意义(P<0.05),治疗后2组比较差异有统计学意义(P<0.05)。结论:补肾解毒方治疗慢性HBV携带者的抗病毒疗效确切。
基金supported by Beijing Science and Technology Commission(No.D121100003912001)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding,Support(No.ZY201402)
文摘Objective To explore the predictive value of baseline HBs Ag level and early response for HBs Ag loss in patients with HBe Ag-positive chronic hepatitis B during pegylated interferon alpha-2a treatment. Methods A total of 121 patients with HBe Ag-positive chronic hepatitis B who achieved HBs Ag loss were enrolled; all patients were treated with PEG-IFNα-2a 180 μg/week. Serum HBV DNA and serological indicators (HBs Ag, anti-HBs, HBe Ag, and anti-HBe) were determined before and every 3 months during treatment. Results The median treatment time for HBs Ag loss was 84 weeks (7-273 weeks), and 74.38% (90 cases) of the patients needed extended treatment (〉 48 weeks). The correlation between baseline HBs Ag levels and the treatment time of HBs Ag loss was significant (B = 14.465, t = 2.342, P = 0.021). Baseline HBs Ag levels together with the decline range of HBs Ag at 24 weeks significantly correlated with the treatment time of HBs Ag loss (B = 29.862, t = 4.890, P = 0.000 and B = 27.993, t = 27.993, P = 0.005). Conclusion Baseline HBs Ag levels and extended therapy are critical steps toward HBs Ag loss. Baseline HBs Ag levels together with early response determined the treatment time of HBs Ag loss in patients with HBe Ag-positive chronic hepatitis B during pegylated interferon alpha-2a treatment.