發(fā)布時(shí)間：2019-07-02 11:20

【摘要】：目的探討年齡、性別、體質(zhì)量指數(shù)(BMI)、治療前HBV DNA載量、ALT、AST、APTT、PT、HBsAg定量、HBeAg定量、P區(qū)基因變異、治療過程中ALT、AST、HBV DNA下降幅度等因素在恩替卡韋治療慢性乙型肝炎(CHB)過程中與應(yīng)答不佳的關(guān)系。方法選擇128例CHB患者,HBeAg陽(yáng)性患者84例,HBeAg陰性患者44例。均初次使用恩替卡韋進(jìn)行抗病毒治療。治療前檢測(cè)上述基線因素及P區(qū)變異,治療過程中ALT、AST、HBV DNA下降幅度等指標(biāo)。在治療后4、12、24周分別檢測(cè)HBV DNA、ALT、AST、HBsAg定量、HBeAg定量。根據(jù)治療24周時(shí)HBV DNA載量,分為完全應(yīng)答組(HBV DNA最低檢測(cè)值下限)和應(yīng)答不佳組(HBV DNA下降2 lg,但仍㧐最低檢測(cè)值下限)。統(tǒng)計(jì)分析上述指標(biāo)與治療應(yīng)答的關(guān)系。結(jié)果年齡、性別、APTT、PT、ALT、AST與治療應(yīng)答無(wú)明顯相關(guān)性(P0.05)。BMI、治療前HBV DNA載量、HBsAg定量與治療應(yīng)答呈負(fù)相關(guān),BMI高、高HBV DNA載量、HBsAg高水平患者多應(yīng)答不佳(P0.05)。HBeAg陽(yáng)性為應(yīng)答不佳的危險(xiǎn)因素(OR=5.431;r=0.358)。HBeAg陽(yáng)性患者,治療24周時(shí),應(yīng)答不佳組HBV DNA下降幅度大(P0.05),rtM204V/I變異率10%時(shí)易出現(xiàn)應(yīng)答不佳(P0.05),rtL180M變異與應(yīng)答無(wú)明顯相關(guān)性(P0.05)。HBeAg陰性患者,治療12周時(shí),完全應(yīng)答組HBV DNA下降幅度大(P0.05),rtM204V/I變異,rtL180M變異均與應(yīng)答無(wú)明顯相關(guān)性(P0.05)。結(jié)論 BMI高、治療前高HBV DNA載量、HBsAg定量高水平、HBeAg陽(yáng)性、rtM204V/I變異率10%的HBeAg陽(yáng)性慢性乙型肝炎患者應(yīng)用恩替卡韋抗病毒治療時(shí)易出現(xiàn)應(yīng)答不佳。
[Abstract]:Objective to investigate the relationship between age, sex, body mass index (BMI), HBV DNA load, ALT,AST,APTT,PT,HBsAg quantitative, HBeAg quantitative, P region gene variation and ALT,AST,HBV DNA decrease in the treatment of chronic hepatitis B (CHB) with entecavir in the treatment of chronic hepatitis B (CHB). Methods 128 patients with CHB, 84 patients with HBeAg positive and 44 patients with HBeAg negative were selected. All patients were treated with entecavir for the first time. Before treatment, the above baseline factors and P region variation were measured, and the decrease of ALT,AST,HBV DNA in the course of treatment was measured. HBV DNA,ALT,AST,HBsAg and HBeAg were measured at 4, 12 and 24 weeks after treatment. According to the HBV DNA load at 24 weeks of treatment, it was divided into complete response group (the lowest limit of (HBV DNA detection value) and poor response group (HBV DNA decreased by 2 lg, but still? The lower limit of the minimum detection value). The relationship between the above indexes and treatment response was statistically analyzed. Results there was no significant correlation between age, sex, APTT,PT,ALT,AST and treatment response (P 0.05). BMI, pre-treatment HBV DNA load, HBsAg quantity were negatively correlated with treatment response. Patients with high BMI, high HBV DNA load and high HBsAg level had poor response (P 0.05). HBsAg positive was a risk factor for poor response (OR=5.431;). R 鈮，

本文編號(hào)：2508891