本文選題：肝炎　切入點(diǎn)：乙型　出處：《重慶醫(yī)學(xué)》2017年23期 　論文類型：期刊論文

【摘要】：目的探索影響慢性乙型肝炎(CHB)初治患者單藥長期抗病毒治療HBeAg血清學(xué)陰轉(zhuǎn)的相關(guān)因素。方法收集使用單藥初治抗病毒2年以上的HBeAg陽性CHB患者的臨床資料,回顧性分析其基線特征及治療期間的生物化學(xué)、病毒學(xué)指標(biāo)與HBeAg陰轉(zhuǎn)的相關(guān)性。結(jié)果 92例患者納入研究,HBeAg陰轉(zhuǎn)組(n=37)與未陰轉(zhuǎn)組(n=55)相比,基線總膽紅素(TBIL)水平較高(P=0.018),天門冬氨酸氨基轉(zhuǎn)移酶-血小板比率指數(shù)(APRI)評(píng)分較高(P=0.024),第24周的HBV DNA轉(zhuǎn)陰率較高(P=0.001)。Logistic回歸分析提示基線APRI評(píng)分(OR=1.398,95%CI:1.034~1.889,P=0.029)及第24周HBV DNA水平(OR=0.727,95%CI:0.532~0.991,P=0.044)是HBeAg陰轉(zhuǎn)的獨(dú)立影響因子。結(jié)論對(duì)于基線APRI評(píng)分及TBIL水平較高的HBeAg陽性CHB患者,可獲得高的HBeAg陰轉(zhuǎn)率,建議在24周后HBV DNA未陰轉(zhuǎn)考慮換用抗病毒方案。
[Abstract]:Objective to explore the factors influencing the seroconversion of HBeAg in patients with chronic hepatitis B (CHB) treated with single drug for long-term antiviral therapy. Methods the clinical data of HBeAg positive CHB patients who were treated with single drug for more than 2 years were collected. The baseline features, biochemical and virological indexes during treatment were analyzed retrospectively. Results 92 patients were included in the study of HBeAg negative conversion group (n = 92) and the control group was compared with the control group (n = 55). The baseline total bilirubin level was higher, the aspartate aminotransferase-platelet ratio index (APRI) score was higher, and the HBV DNA negative rate was higher in the 24th week. Logistic regression analysis indicated that the baseline APRI score OR1.39895 CIW 1.03434 1.889P0.029) and the 24 week HBV DNA level: 0.5320.9920.991P0.044). Conclusion for the patients with HBeAg positive CHB with high baseline APRI score and TBIL level, there is an independent influence factor on HBeAg negativity. High HBeAg negative conversion rate can be obtained. It is suggested that HBV DNA should consider alternative antiviral regimen after 24 weeks.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第二醫(yī)院感染科;重慶市兩江新區(qū)第一人民醫(yī)院消化科;
【分類號(hào)】：R512.62
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本文編號(hào)：1639390