HBV DNA及HBeAg定量在乙型肝炎患者抗病毒治疗方案选择中的指导作用

目的 根据慢性乙型肝炎患者HBV DNA及HBeAg定量高低的不同组合,观察其对IFN、阿德福韦酯(ADV)的治疗效果,寻求抗病毒药物的最佳治疗方案.方法 选择HBeAg阳性患者165例,根据所测HBV DNA及HBeAg定量高低的不同,将其分为A、B、C、D组.每组患者再随机分为IFN治疗组及ADV治疗组,48周时观察不同药物在各组患者治疗效果中的各项指标.结果 IFN治疗组对HBV DNA抑制率、HBV DNA水平下降(≥2lg拷贝/ml)的患者比例、HBV DNA阴转率及ALT复常率与ADV治疗组比较差异均无统计学意义,但在HBeAg定量下降≥500.00 COL/ml的患者比例、HBeAg阴转率、HBeAg血清转换率等项指标比较差异有统计学意义(P<0.05).并提示随着HBV DNA及HBeAg定量的增高,IFN和ADV的疗效依次下降,表现在ADV治疗组更为明显,显示在HBeAg血清转换率方面,IFN疗效明显优于ADV.结论 根据HBV DNA及HBeAg定量的高低,对选择不同的抗病毒治疗方案具有指导作用.

Guidance on select of anti-virus treatment method of HBV DNA and HBeAg quantification with hepatitis B patients

Objective To explore the best treatment for hepatitis B by observing the efficacy d interferon and adefovir dipivoxil (ADV) according to different combination of various quantification of HBV DNA and HBeAg. Methods One hundred and sixty-five hepatitis B antigen-positive patients were divided into four groups (A, B, C, D group) according to different quantification of HBV DNA and HBeAg. Each group was randomly divided into two sub-groups with interferon and the others with ADV. Items were observed in 48 weeks and statistic analysis was made to observe if there was significant difference between two methods in each group. Results There was no difference in the rate of HBV DNA inhibitory activity, HBV DNA clearance and ALT normalization as well as HBV DNA decreasing (level≥2lg copy/ml). But there was significant difference in the rate of HBeAg clearance, HBeAg seroconversion and HBeAg decreasing level ≥500.00 COL/ml (P<0.05). The efficacy decreased following the increasing of HBV DNA and HBeAg quantification, especially in ADV groups. The efficacy of interferon was better in seroconversion rate. Conclusion Quantification of HBV DNA and HBeAg can be the guidance to select different anti-virus methods.