HBsAg定量在慢性乙型肝炎患者干扰素抗病毒治疗中的变化及临床意义

目的研究HBsAg定量在慢性乙型肝炎患者干扰素抗病毒治疗期间的变化及临床意义。 方法收集43例接受IFN-α治疗的HBeAg阳性慢性乙型肝炎患者为研究对象。分别在治疗前和治疗后1、3和6个月时定量检测患者血清HBsAg水平;并同时监测其HBV DNA、HBeAg、HBcAb及ALT的水平。 结果43例患者治疗前和治疗后1、3、6个月时血清HBsAg水平呈下降趋势,差异具有统计学意义（P = 0.029）;治疗1个月时较治疗前有所下降,但差异无统计学意义（t =-1.12、P = 0.304）;治疗3个月和6个月时均较治疗前显著下降,差异具有统计学意义（t =-2.71、P = 0.015,t =-2.71、P = 0.010）;其他不同时间点间比较差异均无统计学意义。IFN-α治疗6个月时患者血清HBsAg下降> 0.5 log₁₀IU/ml组患者ALT复常率高于下降< 0.5 log₁₀IU/ml组,差异具有统计学意义（χ² =5.536、P = 0.019）;下降> 0.5 log₁₀IU/ml组HBeAg阴转率高于下降< 0.5 log₁₀IU/ml组,差异具有统计学意义（χ² = 4.226、P = 0.040）;下降> 0.5 log₁₀IU/ml组HBeAg血清学转换率高于下降< 0.5 log₁₀IU/ml组,差异具有统计学意义（χ² = 4.226、P = 0.040）。 结论HBsAg定量在慢性乙型肝炎患者IFN-α治疗早期呈下降趋势。HBsAg定量在慢性乙型肝炎IFN-α治疗早期下降迅速的患者ALT复常率、HBeAg阴转率及HBeAg血清学转换率均高于下降缓慢者。

Changes and clinical significance of quantitative hepatitis B surface antigen in patients with chronic hepatitis B receiving interferon therapy

ObjectiveTo investigate the changes and clinical significance of quantitative hepatitis B surface antigen (HBsAg) in patients with chronic hepatitis B (CHB) receiving interferon-α (IFN-α) therapy. MethodsTotal of 43 CHB patients with HBeAg-positive who received IFN-α therapy were enrolled. The levels of serum HBsAg were detected before treatment and after 1 month, 3 months and 6 months respectively; while the levels of HBV DNA, HBeAg, HBcAb and ALT were monitored, respectively. ResultsThe levels of serum HBsAg decreased during the IFN-α therpy, with significant difference (P = 0.029); the level of HBsAg at 1 month after treatment was lower than the baseline, but with no significant difference (t =-1.12, P = 0.304); the level of HBsAg at 3 and 6 months after treatment were lower than the baseline, with significant differences (t =-2.71, P = 0.015; t =-2.71, P = 0.010); there were no significant difference between other time points (P all > 0.05). After 6 months treatment, the patients with a reduction of HBsAg > 0.5 log₁₀IU/ml achieved higher ALT normalization rate (χ² =5.536, P = 0.019), HBeAg loss rate (χ² = 4.226, P = 0.040) and HBeAg seroconversion rate (χ² = 4.226, P = 0.040) than the rest patients with a reduction of HBsAg < 0.5 log₁₀IU/ml. ConclusionsThe levels of serum HBsAg in patients with CHB decreased during IFN-α early treatment. The patients whose serum HBsAg decreased faster had higher ALT normalization rates, HBeAg loss rates and HBeAg seroconversion rates than the other ones.