【摘要】 目的评价初治、单药使用替比夫定治疗HBeAg阳性的慢性乙型肝炎(CHB)患者48周的e抗原血清学转换的基线预测因素。方法 97例HBeAg阳性CHB患者分别以基线HBsAg、ALT和HBVDNA水平高低分组,对比两组治疗48周时生化学、病毒学和血清学应答情况。结果基线HBsAg≤1 500 IU/mL组e抗原阴转率和血清学转换率均为42.3%,基线HBsAg>1 500 IU/mL组分别为20%和17.8%,两组比较差异均有统计学意义(P<0.05);基线ALT>5 ULN组e抗原阴转率和血清学转换率均为45.1%,基线ALT≤5 ULN组分别17.4%和15.2%,两组比较差异均有统计学意义(P<0.01);基线HBVDNA<8.0log10copies/mL组和基线HBVDNA≥8.0 log10copies/mL组e抗原阴转率和血清学转换率相比,差异无统计学意义(P>0.05);基线水平HBsAg≤1 500 IU/mL且ALT>5 ULN的CHB患者共40例作为观察组,其余57例患者作为对照组,治疗48周时观察组e抗原阴转率和血清学转换率均为45%,对照组分别为22.8%和21.1%,两组比较差异均有统计学意义(P<0.05)。结论基线HBsAg水平≤1 500 IU/mL和ALT水平>5 ULN的HBeAg阳性慢性乙型肝炎患者,在接受替比夫定治疗48周时,有较高的e抗原转阴率和血清学转换率;基线HBsAg和ALT水平是替比夫定治疗e抗原血清学转换的重要预测因素。更多还原

【Abstract】 Objective To evaluate the baseline forecasting factor of HBeAg seroconversion with telbivudine( LDT) monotherapy in treatment-naive HBeAg-positive chronic hepatitis B( CHB) patients for 48 weeks. Methods Ninety-seven HBeAg-positive CHB patients were divided into two group according to the baseline levels of HBsAg, ALT and HBVDNA; and the biochemical,virological,serological profiles at Week 48 were compared between the two groups. Results The group with baseline levels of HBsAg ≤1500 IU / mL showed higher rates of HBeAg negative( 42. 3% vs 20%; P < 0. 05) and HBeAg seroconversion( 42. 3% vs 17. 8%; P < 0. 05); the group with baseline levels of ALT > 5 ULN showed higher rates of HBeAg negative( 45. 1% vs 17. 4%; P < 0. 01) and HBeAg seroconversion( 45. 1% vs 15. 2%; P < 0. 01). Comparison between the group with baseline levels of HBVDNA ≤ 7. 9 log 10 copies / mL and the group with HBVDNA ≥ 8. 0 log 10 copies / mL showed no significant difference in the rates of HBeAg negative and seroconversion( P > 0. 05); the group with baseline levels of HBsAg ≤ 1 500 IU / mL and ALT > 5 ULN showed higher rates of HBeAg negative( 45% vs 22. 8%; P < 0. 05) and HBeAg seroconversion( 45% vs 21. 1%; P < 0. 05). Conclusion CHB patients accepted LDT treatment with Low baseline HBsAg level( ≤1500 IU / mL) and high baseline ALT level( > 5 ULN) presented satisfactory responses of HBeAg negative and HBeAg seroconversion at week 48; baseline HBsAg and ALT levels are important forecasting factors of HBeAg seroconversion with the treatment of telbivudine( LDT).更多还原