HBsAg定量检测对干扰素治疗慢性乙型肝炎远期疗效的预测价值

发布时间：2018-04-16 13:10

  本文选题：肝炎 + 乙型　； 参考：《实用医学杂志》2015年07期

【摘要】：目的:探讨血清乙肝表面抗原(HBs Ag)定量检测在预测干扰素治疗HBe Ag阳性慢性乙型肝炎远期疗效中的价值。方法:对75例HBe Ag阳性慢性乙型肝炎患者采用聚乙二醇干扰素α-2a,180μg,皮下注射,每周1次,连续48周后停用,完成治疗后随访24周;治疗及随访期间定期检测血清HBs Ag及HBV DNA水平变化。结果:治疗结束后随访24周,根据血清HBV DNA变化情况将患者分为病毒学持续应答组、无应答组及复发组。在治疗第12、24及48周,持续应答组与复发组相比,血清HBV DNA水平差异无显著性,且均明显低于无应答组;而在治疗第12、24及48周,持续应答组血清HBs Ag定量检测水平明显低于复发组,复发组与无应答组差异无显著性。在治疗第12周,血清HBs Ag水平下降幅度≥1 log10 IU/m L对预测持续病毒学应答的敏感性、特异性、阳性预测值及阴性预测值分别为86%、94%、95%及94%;通过受试者工作特征曲线评估治疗第12周血清HBs Ag水平下降幅度≥1 log10 IU/m L对预测患者病毒学持续应答的价值,得出的曲线下面积为0.952。结论:血清HBV DNA水平的变化不能有效预测治疗结束后患者能否达到持续病毒学应答,但血清HBs Ag定量检测可作为预测干扰素治疗HBe Ag阳性慢性乙型病毒性肝炎患者疗效的理想指标。
[Abstract]:Objective: to evaluate the value of serum HBs Agb in predicting the long-term efficacy of interferon in the treatment of chronic hepatitis B (CHB) with HBe Ag positive.Methods: 75 patients with HBe Ag positive chronic hepatitis B were treated with polyethylene glycol interferon 伪 -2a1 180 渭 g, subcutaneously injected once a week, stopped for 48 weeks, followed up for 24 weeks.Serum HBs Ag and HBV DNA levels were measured regularly during treatment and follow-up.Results: the patients were followed up for 24 weeks after treatment. According to the changes of serum HBV DNA, the patients were divided into three groups: virological continuous response group, non-response group and recurrent group.At the 24th and 48th week of treatment, there was no significant difference in serum HBV DNA levels between the continuous response group and the recurrent group, and the level of serum HBV DNA was significantly lower than that in the non-response group, but at the 24th and 48th week after treatment, the serum HBV DNA level in the continuous response group was significantly lower than that in the recurrent group.The level of serum HBs Ag in the continuous response group was significantly lower than that in the recurrent group, but there was no significant difference between the recurrent group and the non-response group.At the 12th week of treatment, the sensitivity and specificity of serum HBs Ag decreased by 鈮，

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