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目的观察慢性乙型病毒性肝炎(chronic hepatitis B,CHB)患者治疗后不同时期外周血谷丙转氨酶(alanine aminotransferase,ALT)、乙肝病毒脱氧核糖核酸(hepatitis B virus deoxyribonucleic acid,HBV DNA)、乙肝表面抗原(hepatitis B surface antigen,HBsAg)、乙肝e抗原(hepatitis B e antigen,HBeAg)滴度的变化,并探讨其预测HBeAg血清学转换的价值。方法对72例选择干扰素(interferon,IFN)治疗的HBeAg阳性CHB患者随访48周,在治疗0、12、24、48周收集患者的血清,定量检测HBsAg、HBeAg、HBV DNA、ALT水平。结果基线ALT、HBeAg水平与治疗应答相关。治疗12、24周时HBsAg<4.33、4.07(lg IU/ml),下降率>65%、47%,治疗12、24周时HBeAg<2.38、0.87(lg S/CO),下降率>71%、95%预测治疗48时出现HBeAg血清学转换的敏感性、特异性高(均有P<0.05)。结论 IFN治疗HBeAg阳性CHB患者时,动态监测HBsAg、HBeAg的水平变化能作为预测是否出现HBeAg血清学转换的良好指标。
Objective To observe the changes of peripheral blood levels of alanine aminotransferase (ALT), hepatitis B virus deoxyribonucleic acid (HBV DNA) and hepatitis B surface in patients with chronic hepatitis B (CHB) (HBsAg), hepatitis B e antigen (HBeAg) titer, and to explore the value of predicting HBeAg seroconversion. Methods Seventy-two patients with HBeAg-positive CHB treated with interferon (IFN) were followed up for 48 weeks. Serum samples were collected at 0, 12, 24 and 48 weeks after treatment. The levels of HBsAg, HBeAg, HBV DNA and ALT were detected quantitatively. Results Baseline ALT and HBeAg levels correlated with response to treatment. HBsAg <4.33,4.07 (lg IU / ml) at 12 and 24 weeks of treatment, the decreasing rate was> 65% and 47%, and the HBeAg <2.38 and 0.87 (lg S / CO) , And 95% predicted the sensitivity and specificity of HBeAg seroconversion at 48 (all P <0.05). Conclusions When IFN is used to treat patients with HBeAg-positive CHB, the dynamic changes of HBsAg and HBeAg levels can be used as a good predictor of HBeAg seroconversion.