【摘要】 目的分析聚乙二醇干扰素α(PegIFN-α)治疗HBeAg阳性慢性乙型肝炎(CHB)疗效的预测因素。方法对70例HBeAg阳性CHB患者予标准剂量PegIFN-α-2a或PegIFN-α-2b治疗。将治疗48周时,肝功能恢复正常、HBV DNA低于检测下限(<103copies/ml)、伴或不伴HBeAg和/或HBsAg的血清转换者定义为应答组(43例),其余为无应答组(27例)。结果应答组患者基线ALT较高(≥5×ULN)、HBV DNA载量较低(<10~6 copies/ml)、HBsAg水平较低(<5000IU/ml)和HBeAg水平较低(<500S/CO)者的比例高于无应答组(P<0.01)。应答组出现快速病毒学应答率69.8%(30/43),高于无应答组的48.1%(13/27)(P<0.01)。治疗12周时,HBsAg滴度下降幅度预测疗效的灵敏度为65.1%,特异度为92.6%。基线ALT≥5×ULN和12周时HBV DNA是影响预后的独立危险因素。结论基线ALT、HBsAg、HBeAg、HBV DNA水平和治疗12周时的HBV DNA和HBsAg下降幅度对PegIFN-α治疗HBeAg阳性CHB患者的疗效有预测意义。更多还原

【Abstract】 Objective To analyze the factors predicting therapeutic efficiency of polyethylene glycol interferon-α(PegIFN-α)in the patients with HBeAg positive chronic hepatitis B(CHB).Methods Seventy patients with HBeAg-positive CHB were treated with standared dose of PegIFN-α-2a or PegIFN-α-2bfor at least 48 weeks.Of 70 patients,43cases after treament were responsive to the treatment and manefested as that the liver function returned to normal,HBV DNA was lower than103copies/ml with or without serum conversion of HBeAg and/or HBsAg.Twenty-seven patients were not responsive to the treatment.Results Compared to the patients without response to the treatment,the patients responsive to the treatment had a baseline ALT≥5×ULN or higher,low HBV DNA(<10~6copies/ml),low level of HBsAg(<5000IU/ml),and low level of HBeAg(<500S/CO)(P<0.01),and rapid virological response rate(HBV DNA dropped to below the detection limit after treated for 12weeks)was higher(69.8% vs.48.2%)(P<0.01).The sensitivity and specificity of the amplitude of HBsAg dropping in predicting therapeutic efficacy were 65.1% and 92.6%,respectively.The baseline ALT≥5×ULN and HBV DNA treated for 12 weeks were the independent risk factors affecting the prognosis.Conclusion The indicators of baseline levels of ALT,HBsAg,HBeAg,HBV DNA,and HBV DNA decline after treated for 12 weeks can be used to predict therapeutic efficacy in the patients with HBeAg positive CHB.更多还原