恩替卡韦治疗慢性乙型肝炎过程中应答不佳相关因素分析
发布时间：2019-07-02 11:20
【摘要】：目的探讨年龄、性别、体质量指数(BMI)、治疗前HBV DNA载量、ALT、AST、APTT、PT、HBsAg定量、HBeAg定量、P区基因变异、治疗过程中ALT、AST、HBV DNA下降幅度等因素在恩替卡韦治疗慢性乙型肝炎(CHB)过程中与应答不佳的关系。方法选择128例CHB患者,HBeAg阳性患者84例,HBeAg阴性患者44例。均初次使用恩替卡韦进行抗病毒治疗。治疗前检测上述基线因素及P区变异,治疗过程中ALT、AST、HBV DNA下降幅度等指标。在治疗后4、12、24周分别检测HBV DNA、ALT、AST、HBsAg定量、HBeAg定量。根据治疗24周时HBV DNA载量,分为完全应答组(HBV DNA最低检测值下限)和应答不佳组(HBV DNA下降2 lg,但仍㧐最低检测值下限)。统计分析上述指标与治疗应答的关系。结果年龄、性别、APTT、PT、ALT、AST与治疗应答无明显相关性(P0.05)。BMI、治疗前HBV DNA载量、HBsAg定量与治疗应答呈负相关,BMI高、高HBV DNA载量、HBsAg高水平患者多应答不佳(P0.05)。HBeAg阳性为应答不佳的危险因素(OR=5.431;r=0.358)。HBeAg阳性患者,治疗24周时,应答不佳组HBV DNA下降幅度大(P0.05),rtM204V/I变异率10%时易出现应答不佳(P0.05),rtL180M变异与应答无明显相关性(P0.05)。HBeAg阴性患者,治疗12周时,完全应答组HBV DNA下降幅度大(P0.05),rtM204V/I变异,rtL180M变异均与应答无明显相关性(P0.05)。结论 BMI高、治疗前高HBV DNA载量、HBsAg定量高水平、HBeAg阳性、rtM204V/I变异率10%的HBeAg阳性慢性乙型肝炎患者应用恩替卡韦抗病毒治疗时易出现应答不佳。
[Abstract]:Objective to investigate the relationship between age, sex, body mass index (BMI), HBV DNA load, ALT,AST,APTT,PT,HBsAg quantitative, HBeAg quantitative, P region gene variation and ALT,AST,HBV DNA decrease in the treatment of chronic hepatitis B (CHB) with entecavir in the treatment of chronic hepatitis B (CHB). Methods 128 patients with CHB, 84 patients with HBeAg positive and 44 patients with HBeAg negative were selected. All patients were treated with entecavir for the first time. Before treatment, the above baseline factors and P region variation were measured, and the decrease of ALT,AST,HBV DNA in the course of treatment was measured. HBV DNA,ALT,AST,HBsAg and HBeAg were measured at 4, 12 and 24 weeks after treatment. According to the HBV DNA load at 24 weeks of treatment, it was divided into complete response group (the lowest limit of (HBV DNA detection value) and poor response group (HBV DNA decreased by 2 lg, but still? The lower limit of the minimum detection value). The relationship between the above indexes and treatment response was statistically analyzed. Results there was no significant correlation between age, sex, APTT,PT,ALT,AST and treatment response (P 0.05). BMI, pre-treatment HBV DNA load, HBsAg quantity were negatively correlated with treatment response. Patients with high BMI, high HBV DNA load and high HBsAg level had poor response (P 0.05). HBsAg positive was a risk factor for poor response (OR=5.431;). R 鈮，
本文编号：2508891
[Abstract]:Objective to investigate the relationship between age, sex, body mass index (BMI), HBV DNA load, ALT,AST,APTT,PT,HBsAg quantitative, HBeAg quantitative, P region gene variation and ALT,AST,HBV DNA decrease in the treatment of chronic hepatitis B (CHB) with entecavir in the treatment of chronic hepatitis B (CHB). Methods 128 patients with CHB, 84 patients with HBeAg positive and 44 patients with HBeAg negative were selected. All patients were treated with entecavir for the first time. Before treatment, the above baseline factors and P region variation were measured, and the decrease of ALT,AST,HBV DNA in the course of treatment was measured. HBV DNA,ALT,AST,HBsAg and HBeAg were measured at 4, 12 and 24 weeks after treatment. According to the HBV DNA load at 24 weeks of treatment, it was divided into complete response group (the lowest limit of (HBV DNA detection value) and poor response group (HBV DNA decreased by 2 lg, but still? The lower limit of the minimum detection value). The relationship between the above indexes and treatment response was statistically analyzed. Results there was no significant correlation between age, sex, APTT,PT,ALT,AST and treatment response (P 0.05). BMI, pre-treatment HBV DNA load, HBsAg quantity were negatively correlated with treatment response. Patients with high BMI, high HBV DNA load and high HBsAg level had poor response (P 0.05). HBsAg positive was a risk factor for poor response (OR=5.431;). R 鈮，
本文编号：2508891
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