摘要
目的探讨聚乙二醇干扰素α-2a治疗新疆地区不同HBV基因分型乙型肝炎(乙肝)患者的临床疗效。方法选择56例符合纳入和排除标准的慢性乙型肝炎患者,均采用聚乙二醇干扰素α-2a抗病毒治疗,疗程为6个月。检测所有患者的基因型,并对不同基因型患者乙肝表面抗原(HBsAg)、乙肝e抗原(HBeAg)、血清HBeAg定量、乙肝病毒基因(HBV-DNA)定量、谷丙转氨酶(ALT)、HBsAg阴转率、HBeAg阴转率、血清HBeAg转换率、HBV-DNA阴转率以及ALT复常率进行比较。结果 18例HBeAg阳性患者中HBsAg阴转2例,血清HBeAg转换4例,血清学转换率为22.22%;56例患者HBV基因型以C型为主,共36例,其余为B型,C型患者HBVDNA显著高于B型,差异有统计学意义(P<0.05);随着治疗时间的延长,两组患者的HBV-DNA阴转率以及ALT复常率成显著升高趋势,差异有统计学意义(P<0.05),HBsAg阴转率、HBeAg阴转率以及血清HBeAg转换率无明显改变(P>0.05),且相同时间点B型和C型患者上述指标差异均无统计学意义(P>0.05);与治疗前比较,治疗后两组HBsAg定量均无明显差异,2种基因型相同时间点HBsAg定量比较差异无统计学意义(P>0.05)。结论新疆地区乙肝患者聚乙二醇干扰素α-2a抗病毒治疗HBsAg阴转率降低,应答情况不理想,疗效欠佳,且基因型对疗效无明显影响。
Objective The aims of this study were to investigate the effects of different genotypes of hepati- tis B virus to PEG-INF-α-2a in Xinjiang. Methods A total of 56 patients with chronic hepatitis B were de- termined, according to the integration and elimination stan-dard. After 6-month peg-interferon alfa-2a anti- viral treatmen,all patients were analyzed according to their HBsAg/anti-HBs profile, HBeAg/anti-HBe profile, viral load, and Alanine aminotransferase （ALT） serum level. Results There were 2 patients who have HBsAg seroclearance,and 4 patients who have hepatitis t3 antigen （HBeAg） seroconversion in 18 pa- tients with HBeAg-positive chronic hepatitis B. The conversion rate is 22.22%. There were 36 patientswhose genotype identified was C in 56 individuals, and the rests were B. Patients infected by genotype C HBV also have a better response than those infected by genotype B HBV （P〈0.05） ; With the extension of peg-interferon treat ment, patients infected by genotype C HBV also have a better response than those infected by genotype B HBV on viral load and alanine aminotransferase serum level （P 〈0.05）. However, The HBsAg seroclearance and HBeAg seroconversion have not response to peg-interferon treatment （P 〉0.05）. And the same point of time in patients with type B and C above indicators had no significant differ- ence （P 〉0.05）. Compared with before treatment, after treatment in the two groups were no significant differences of HBsAg quantitative, two genotypes of the same point in time HBsAg quantitative compari- son difference also has no statistical significance （P 〉0.05）. Conclusion Based on the results of this stud- y, we find HBsAg level is not a useful on-treatment monitoring tool to predict the response to peg-interfer- on alfa-2a, and the genotypes of hepatitis B virus is not good enough as a marker to guide patient selection for peg-interferon treatment in Xinjiang.
出处
《新疆医科大学学报》
CAS
2015年第9期1124-1127,共4页
Journal of Xinjiang Medical University
基金
新疆兵团科技计划项目(2013AB028)
新疆生产建设兵团医院项目(LC2014012)
