【作者】 何英；

【导师】 龚国忠；

【作者基本信息】 中南大学 ， 临床医学（专业学位）， 2022， 硕士

【摘要】 目的:研究HBV pg RNA在预测核苷(酸)类似物经治慢性乙型病毒性肝炎患者联合或序贯Peg-IFNα-2b治疗HBs Ag清除的临床意义。方法:病人来源于中南大学湘雅二医院感染科门诊2019年1月至2021年1月102名经核苷(酸)类似物治疗且获得HBs Ag<1500 IU/m L、HBV DNA<1000 IU/m L及HBe Ag阴性的慢性HBV感染者,采用Peg-IFNα-2b治疗48周。收集患者在基线、12周、24周和48周的血清,应用实时荧光定量PCR法对HBV pg RNA进行检测。分析HBV pg RNA与HBs Ag清除的关系。结果:(1)在研究人群基线HBV pg RNA检出率低(28.43%)。(2)经过Peg-IFNα-2b治疗,HBV pg RNA 12周基本转阴(阴转率96.55%)。(3)HBV pg RNA在治疗基线、12周、24周均不是预测HBs Ag清除的独立影响因子(p>0.05)。(4)HBs Ag是唯一能够预测患者基线、12周、24周时间节点Peg-IFNα-2b治疗48周时HBs Ag阴转的独立因素。结论:HBV pg RNA不能预测Peg-IFNα-2b治疗核苷(酸)类似物经治6个月及以上慢性乙型病毒性肝炎患者HBs Ag的清除,而HBs Ag可作为HBs Ag清除的预测指标。图4幅,表7个,参考文献59篇更多还原

【Abstract】 Objective:To investigate the effect of HBV pg RNA in predicting HBs Ag clearance in nucleoside(acid)analog-treated patients with chronic hepatitis B treated with Peg-IFNα-2b。Methods:The patients came from 102 outpatients of the Department of Infectious Diseases,Second Xiangya Hospital of Central South University from January 2019 to January 2021,who were treated with nucleoside(acid)analogs and obtained HBs Ag < 1500 IU/m L,HBV DNA < 1000 IU/m L and HBe Ag negative Patients with chronic HBV infection were treated with Peg-IFNα-2b for 48 weeks.The serum of patients at baseline,12 weeks,24 weeks and 48 weeks was collected,and real-time quantitative PCR was used to detect HBV pg RNA.The relationship between HBV pg RNA and HBs Ag clearance was analyzed.Results :(1)The detection rate of HBV pg RNA at baseline in the study population was low(28.43%).(2)After Peg-IFNα-2b treatment,HBV pg RNA was basically negative at 12 weeks(negative conversion rate was96.55%).(3)HBV pg RNA was not an independent factor predicting HBs Ag clearance at baseline,12 weeks,and 24 weeks of treatment(p >0.05).(4)HBs Ag was the only independent factor that could predict HBs Ag negativity at baseline,12 weeks,and 24 weeks of Peg-IFNα-2b treatment at 48 weeks.Conclusion:HBV pg RNA cannot predict HBs Ag clearance in nucleoside(acid)analogs patients with chronic hepatitis B treated with nucleoside(acid)analogs for 6 months or more treated with Peg-IFNα-2b.HBs Ag can be used as a predictor of HBs Ag clearance.更多还原