目的：探讨影响急性乙型肝炎患者HBsAg转阴的因素。方法将2007年2月至2013年2月在周口市中心医院感染科就诊的106例急性乙型肝炎（AHB）患者纳入本研究，每3个月检查肝功能、乙型肝炎血清学标志物、HBV DNA，随访12个月，并应用型特异性引物nPCR法对HBV进行基因分型。计数资料组间比较采用χ2检验，计量资料组间比较用t检验。结果血清HBsAg持续阳性超过6个月或12个月者与HBsAg转阴者相比，前者入院时的ALT峰值低于后者（718±696 vs 1282±913 U/L，622±514 vs 1203±924 U/L，P＜0．05），而入院时HBV DNA高于后者[（6．8±1．4）vs （5．2±1．5）log10拷贝/ml，（7．3±1．6）vs （5．4±1．5）log10拷贝/ml，P＜0．05]；感染A基因型者6、12个月时HBsAg转阴率低于B、D型（75．0％vs 89．5％、100％，83．3％vs 97．4％、100％，P＜0．05）。结论 AHB患者血清HBsAg转阴率与ALT峰值、HBV DNA、基因型等因素有关。%Objective To investigate the factors related to negative conversion of HBsAg in patients with acute hepatitis B (AHB).Meth-ods A total of 106 AHB patients who were admitted to the Department of Infectious Diseases,Zhoukou Central Hospital from February 2007 to February 2013 were recruited.Liver function,five serological markers of HBV infection (HBsAg,HBeAg,anti-HBs,anti-HBe,and anti-HBc),and HBV-DNA were measured every three months.All patients were followed up for 12 months.The major HBV genotypes (A through D)were determined by type-specific primer nested PCR.Categorical data were expressed as rates and compared with χ2 test;continuous data were expressed as mean ±SD and analyzed by t-test.Results When just admitted to our hospital,compared with the pa-tients with negative conversion of HBsAg,AHB patients with HBsAg persisting for more than 6 or 12 months had a significantly lower peak level of alanine aminotransferase (ALT)(718 ±696 vs 1282 ±913 U/L,622 ±514 vs 1203 ±924 U/L,P<0.05)and a significantly high-er level of HBV-DNA (6.8 ±1.4 vs 5.2 ±1.5 log10 copies/ml,7.3 ±1.6 vs 5.4 ±1.5 log10 copies/ml,P<0.05).The HBsAg clear-ance rate in patients with HBV genotype A was significantly lower than that in patients with HBV genotype B or D (75.0% vs 89.5% or 100%,83.3% vs 97.4% or 100%,P<0.05).Conclusion The HBsAg clearance rate in AHB patients may be associated with HBV genotypes,peak level of ALT,and HBV-DNA.
展开▼
