影响慢乙型肝炎初治抗病毒HBeAg阴转的因素分析

发布时间：2018-03-20 14:01

  本文选题：肝炎　切入点：乙型　出处：《重庆医学》2017年23期 　论文类型：期刊论文

【摘要】：目的探索影响慢性乙型肝炎(CHB)初治患者单药长期抗病毒治疗HBeAg血清学阴转的相关因素。方法收集使用单药初治抗病毒2年以上的HBeAg阳性CHB患者的临床资料,回顾性分析其基线特征及治疗期间的生物化学、病毒学指标与HBeAg阴转的相关性。结果 92例患者纳入研究,HBeAg阴转组(n=37)与未阴转组(n=55)相比,基线总胆红素(TBIL)水平较高(P=0.018),天门冬氨酸氨基转移酶-血小板比率指数(APRI)评分较高(P=0.024),第24周的HBV DNA转阴率较高(P=0.001)。Logistic回归分析提示基线APRI评分(OR=1.398,95%CI:1.034~1.889,P=0.029)及第24周HBV DNA水平(OR=0.727,95%CI:0.532~0.991,P=0.044)是HBeAg阴转的独立影响因子。结论对于基线APRI评分及TBIL水平较高的HBeAg阳性CHB患者,可获得高的HBeAg阴转率,建议在24周后HBV DNA未阴转考虑换用抗病毒方案。
[Abstract]:Objective to explore the factors influencing the seroconversion of HBeAg in patients with chronic hepatitis B (CHB) treated with single drug for long-term antiviral therapy. Methods the clinical data of HBeAg positive CHB patients who were treated with single drug for more than 2 years were collected. The baseline features, biochemical and virological indexes during treatment were analyzed retrospectively. Results 92 patients were included in the study of HBeAg negative conversion group (n = 92) and the control group was compared with the control group (n = 55). The baseline total bilirubin level was higher, the aspartate aminotransferase-platelet ratio index (APRI) score was higher, and the HBV DNA negative rate was higher in the 24th week. Logistic regression analysis indicated that the baseline APRI score OR1.39895 CIW 1.03434 1.889P0.029) and the 24 week HBV DNA level: 0.5320.9920.991P0.044). Conclusion for the patients with HBeAg positive CHB with high baseline APRI score and TBIL level, there is an independent influence factor on HBeAg negativity. High HBeAg negative conversion rate can be obtained. It is suggested that HBV DNA should consider alternative antiviral regimen after 24 weeks.
【作者单位】： 重庆医科大学附属第二医院感染科;重庆市两江新区第一人民医院消化科;
【分类号】：R512.62
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本文编号：1639390