【摘要】 目的 比较乙型肝炎表面抗原(H-BsAg)、乙型肝炎e抗原(HBeAg)与乙肝病毒DNA(HBV-DNA)对干扰素治疗HBeAg阳性慢性乙型肝炎48周HBeAg血清学转换的临床预测价值。方法252例接受干扰素治疗的HBeAg阳性慢性乙型肝炎患者为研究对象,分为HBeAg血清学转换组(83例)与未转换组(169例)。利用受试者工作特征(ROC)曲线计算灵敏度、特异度、阳性预测值(PPV)与阴性预测值(NPV)。结果 12周与24周HBeAg分别以90 S/CO与25 S/CO为临界值时,其预测治疗48周HBeAg血清学转换的灵敏度、特异度、PPV,NPV分别为0.852,0.639,0.680,0.828与0.899,0.663,0.763,0.845,24周的HBV-DNA载量与较基线下降幅度也具有较高灵敏度与特异度。结论HBeAg血清定量值为干扰素治疗慢性乙型肝炎血清学转换最佳预测指标,此外,治疗24周HBV-DNA载量与较基线下降幅度也具有一定预测价值。更多还原

【Abstract】 Objective To compare the clinical value of quantitative serum hepatitis B surface antigen(HBsAg),hepatitis B eantigen(HBeAg) and hepatitis B virus(HBV-DNA) for predicting HBeAg seroconversion in the treatment of HBeAg-positive chronic hepatitis B(CHB) by pegylated interferon(PEG-IFN).Methods 252 HBeAg-positive chronic hepatitis B patients who received PEG-IFN were enrolled.They were divided in HBeAg seroconversion group(83 cases) and non- HBeAg seroconversion group(169 cases).Sensitivity,specificity,positive predictive value(PPV) and negative predictive value(NPV) were calculated by receiver operating characteristic(ROC) curve.Results When cut-off point of HBeAg was set to90 S/CO for 12 weeks and 25 S/CO for 24 weeks,the sensitivity,specificity,PPV and NPV of HBeAg seroconversion after48 weeks treatment were 0.852,0.639,0.680,0.828 and 0.899,0.663,0.763,0.845 respectively.At week 24 of treatment,HBV-DNA load and decline also had higher sensitivity and specificity.Conclusion Serum of HBeAg level was strong predictor factor for HBeAg seroconversion,HBV-DNA and decline also had higher predictive value at week 24 of treatment.更多还原