【摘要】 目的:探讨替比夫定治疗HBeAg阳性慢性乙型肝炎(CHB)患者HBeAg血清学转换的预测因素。方法:选取2011年9月至2015年8月广西医科大学第一附属医院感染科门诊治疗的77例HBeAg阳性CHB患者,均采用替比夫定口服治疗。根据随访终点时是否出现HBeAg血清学转换分为转换组(34例)和未转换组(43例)。比较两组患者相关临床指标的差异,并采用多因素Logistic回归分析法分析影响HBeAg血清学转换的因素。结果:两组年龄、性别、基线HBV DNA、基线总胆红素(TBIL)、白蛋白(ALB)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆汁酸(TBA)、碱性磷酸酶(ALP)、前白蛋白(PALB)、胆碱酯酶(CHE)等指标比较差异均无统计学意义(均P>0.05),而两组基线球蛋白(GLO)水平比较差异具有统计学意义(P<0.05);多因素Logistic回归分析结果显示:基线低GLO水平为HBeAg血清学转换的独立预测因素(P<0.05)。结论:基线低GLO水平可能为替比夫定治疗HBeAg阳性CHB患者HBeAg血清学转换的独立预测因素。更多还原

【Abstract】 Objective: To investigate the factors for HBeAg seroconversion in chronic hepatitis B(CHB)patients with telbivudine treatment. Methods: 77 HBeAg positive CHB patients treated with telbivudine in our hospital from September 2011 to August 2015 were selected. At the end of the follow-up,34 patients remained HBeAg positive(non-seroconversion group)and 43 patients achieved HBeAg seroconversion(seroconversion group).The factors influencing HBeAg seroconversion were analyzed by univariate analysis and multiple logistic regression analysis. Results: There were no significant differences in the age,gender,baseline HBV DNA,baseline total bilirubin(TBIL),albumin(ALB),aspartate transaminase(AST), alanine aminotransferase(ALT),total bile acid(TBA),alkaline phosphatase(ALP),prealbumin(PALB) and cholinesterase(CHE)levels between the two groups(P>0. 05). A significant difference was found in baseline globulin(GLO)level between the two groups(P<0. 05). Mulvariate logistic regression analysis showed that the baseline GLO was the factor influencing HBeAg seroconversion in CHB patients after telbivudine treatment. Conclusion: Baseline GLO may be the influencing factor for HBeAg seroconversion in HBeAg positive CHB patients with telbivudine treatment.更多还原