【摘要】 目的观察聚乙二醇干扰素α-2a(PEG-IFNα-2a)治疗HBeAg阳性慢性乙型肝炎(CHB)的疗效及其影响因素。方法将78例中疗程≥48周的45例纳入研究,治疗结束后随访24周。观察生化学、病毒学及血清学应答,对各指标进行分析。结果治疗24周时HBeAg定量水平≤10s/co的患者可获得较高的HBeAg血清学转换率,较治疗24周时的HBV DNA载量更能准确预测其HBeAg血清学转换率;治疗36周时血清HBsAg水平下降>2lg或绝对值≤10IU/mL的患者可获得较高的HBsAg阴转率,较治疗36周时的HBV DNA载量更能准确预测其HBsAg阴转率。logistic回归分析显示,治疗36周时HBsAg水平及HBsAg水平较基线的下降值是观察结束时HBsAg清除的预测因素。结论治疗24周时的HBeAg定量水平可作为HBeAg血清学转换的预测因素,治疗36周时HBsAg水平及HBsAg水平较基线的下降值是HBsAg清除的预测因素。更多还原

【Abstract】 Objective To evaluate the efficacy of PEG-IFNα-2ain hepatitis B e antigen(HBeAg)-positive chronic hepatitis B(CHB)patients and predicting factor.Methods Seventy-eight HBeAg-positive CHB patients were treated with PEGIFNα-2afor 48 weeks and off-treatment follow-up 24 weeks and compared the level of ALT,HBV DNA,HBeAg and HBsAg with the method of logistic multiple regression.Forty-five patients with treatment more than 48 weeks were enrolled.ResultsSerum HBeAg level lower than 10s/co at 24 weeks was a better predictor for subsequent HBeAg seroconversion than HBV DNA level at 24 weeks.Serum HBsAg decline(>2log10IU/mL)or HBsAg level≤10IU/mL at 36 weeks predict better than HBV DNA level at 36 weeks for subsequent HBsAg loss.Multiple logistic regression analysis and ROC curves indicated that a decline of HBsAg levels from baseline through treatment 36 weeks or HBsAg levels at 36 weeks were important predictors for HBsAg loss at the end of follow-up.Conclusion HBeAg level at 24 weeks may identify those with a greater likelihood of achieving HBeAg seroconversion.HBsAg levels at 36 weeks and a decline of HBsAg levels from baseline to 36 weeks were significantly important predictors for HBsAg loss.更多还原