摘要
目的分析HBeAg阴性慢性乙型肝炎患者在应用核苷（酸）类抗病毒药物治疗3年期间HBsAg定量的动态变化以及其停药前水平对持续病毒学应答的预测作用。方法115例HBeAg阴性慢性乙型肝炎患者应用核苷类药物抗病毒治疗，每隔半年检测HBsAg定量，分析3年HBsAg的动态变化。有35例患者3年后陆续停药，继续随访1年，观察停药后疗效持续性。分析停药患者停药时HBsAg定量与疗效持续性的关系。结果115例HBeAg阴性患者随着使用核苷（酸）类抗病毒药物的治疗，HBsAg定量逐年有下降趋势且有统计学差异（F＝3.01，P＜0.05）。HBsAg定量在基线为（3.13±0.79）logIU/ml，在治疗6、12、18、24、30、36个月分别为（3.11±0.86）、（3.06±0.85）、（2.98±0.92）、（2.91±0.84）、（2.83±0.82）、（2.76±0.95）logIU/ml（与基线比较，t值分别为0.18、0.65、1.33、2.05、2.83、3.21；P值分别为0.85、0.52、0.19、0.04、0.005、0.002）。持续病毒学应答组（13例）与病毒学复发组（22例）在停药时HBsAg水平分别为（2.21±0.73）、（2.89±0.95）logIU/ml，两组病例的停药时HBsAg水平比较有统计学差异（t＝2.03，P＝0.03）。结论HBeAg阴性慢性乙型肝炎患者HBsAg定量均随着核苷（酸）类抗病毒药物治疗时间的延长而下降。停药患者停药时HBsAg定量低水平与更好的持续病毒学应答相关。
Objective To analyze antiviral nucleotide-induced dynamic change of HBsAg quantity over 3-year follow-up during the period of sustained viral response and the prognostic value of HBsAg level prior to drug-withdrawal for sustained viral response in patients with chronic hepatitis B negative for HBeAg. Methods 115 patients with chronic hepatitis B negative for HBeAg were treated with antiviral nucleotide. HBsAg quantity was measured every half year, and the dynamic change of 3-year was analyzed. 35 patients withdrew nucleotide successively 3 years later, they were followed up 1 more year to observe the persistence of curative effect after drug-withdrawal. The relationship between HBsAg quantity at point of drug-withdrawal and the persistence of curative effect was analyzed. Results HBsAg quantity of 115 patients with chronic hepatitis B negative for HBeAg decreased gradually with the prolongation of antiviral therapy in 3-year follow-up period （F=3.01, P〈0.05）. HBsAg quantity at baseline was （3.13±0.79） logIU/ml, and those after 6, 12, 18, 24, 30, 36 months were （3.11±0.86）, （3.06±0.85）, （2.98±0.92）, （2.91±0.84）, （2.83±0.82）, （2.76±0.95） logIU/ml respectively （compared with the baseline, t=0.18, 0.65, 1.33, 2.05, 2.83, 3.21, P=0.85, 0.52, 0.19, 0.04, 0.005, 0.002）. After drug-withdrawal, HBsAg quantity in the group of sustained off-treatment virological response （n=13） and the group of virological recurrence （n=22） were （2.21±0.73）, （2.89±0.95） logIU/ml （t=2.03, P=0.03）. Conclusions HBsAg quantity of patients with chronic hepatitis B negative for HBeAg decreased with prolongation of antiviral therapy. The patients who had lower HBsAg quantity at point of drug-withdrawal had better persistence of curative effect after drug-withdrawal.
出处
《国际医药卫生导报》
2016年第21期3240-3242,共3页
International Medicine and Health Guidance News
基金
广州市医药卫生科技项目（201102A213207）
关键词
慢性乙型肝炎
肝炎表面抗原
核苷(酸)类抗病毒药
持续病毒学应答
Chronic hepatitis B
Hepatitis B surface antigen
Nucleotide （acid） antivirus drug
Sustained off-treatment virological response
