恩替卡韦应答不佳的HBeAg阳性慢性乙型肝炎患者的基线特征研究

摘要

目的 探讨使用ETV治疗应答不佳的HBeAg阳性慢性乙型肝炎患者的基线特征.方法 回顾性研究2016年1月至2019年1月在首都医科大学附属北京地坛医院就诊接受恩替卡韦治疗应答不佳的70例患者.随访基线及治疗12周、24周、48周时的HBeAg定量、HBV DNA定量、ALT、TBIL、ALB、Cre水平.根据治疗48周时的HBV DNA是否＞3 log10 IU/ml,将70例应答不佳患者分为高应答组(2 log10 IU/ml≤HBV DNA≤3 log10 IU/ml)和低应答组(HBV DNA＞3 log10 IU/ml).计量资料组间比较采用独立样本￡检验;计数资料组间比较采用x2检验.结果 抗病毒治疗前两组患者的TBIL水平比较差异有统计学意义(P值＜0.05);治疗12周时HBV DNA定量、TBIL下降程度在两组间比较差异有统计学意义(P值＜0.05);治疗24周时HBV DNA定量、ALT水平、ALT下降情况、TBIL下降情况在两组间比较差异均有统计学意义(P值＜0.05).结论 基线TBIL水平、治疗24周后HBV DNA水平和ALT的下降程度是抗病毒应答效率的影响因素.%Objective To investigate the baseline characteristics of HBeAg-positive chronic hepatitis B patients with poor response to entecavir (ETV).Methods A retrospective study of 70 patients who were partial virologic responders to ETV in Beijing Ditan Hospital from January 2016 to January 2019 was conducted.Data of HBeAg quantification,HBV DNA quantification,value of alanine amimnotransferase (ALT),total bilirubin (TBIL),albumin (ALB),and creatinine (Cre) levels at baseline and follow-up point were collected.According to HBV DNA level after 48 weeks,patients were divided into high response group (2 log10 IU/ml≤ HBV DNA ≤ 3 log10 IU/ml) and low response group (HBV DNA＞3 log10 IU/m).The independent sample t test was used to compare the measurement data between the two groups;the x2 test was used to compare the categorical data between the two groups.Results There were significant differences in the level of TBIL between the two groups before initiating the antiviral treatment (P＜0.05).The difference of HBV DNA quantification and TBIL decline degree at 12 weeks were statistically significant (P＜0.05).Comparison of HBV DNA quantification,ALT level,ALT decline degree and TBIL decline degree at 24 weeks were also statistically significant (P＜ 0.05).Conclusions Baseline TBIL levels,HBV DNA levels and ALT decline degree after 24 weeks are influencing factors that affect the efficiency of antiviral response.