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目的:探讨用恩替卡韦治疗慢性乙肝患者过程中血清乙肝大蛋白(HBV-LHBs)的变化与抗病毒疗效的关系。方法:分别检测30例用恩替卡韦抗病毒治疗的慢性乙型肝炎患者在0个月、6个月、12个月、18个月、24个月时的LHBs、HBV DNA、HBeAg的水平。结果:30例乙肝患者在入组时的LHBs阳性检出率90.00%(27/30)与HBV-DNA的阳性检出率100.00%(30/30)比较差异无统计学意义(χ2=3.16,P>0.05),LHBs的含量(OD值)与HBV-DNA拷贝数的对数呈正相关性(r=0.885)。LHBs的阳性检出率与HBeAg的阳性检出率(73.33%)比较差异有统计学意义(χ2=2.78,P>0.05)。恩替卡韦组0个月、6个月、12个月、18个月、24个月抗病毒治疗无效风险预测值分别为0.28、036、0.46、0.57、0.67。结论:血清LHBs与HBV-DNA有较好的一致性,可作为一个新的判断病毒复制的指标。抗病毒治疗过程LHBs阳性持续时间越长,预示着抗病毒治疗无效的风险性越大。
Objective: To investigate the relationship between changes of serum hepatitis B major protein (HBV-LHBs) and antiviral efficacy in the treatment of chronic hepatitis B patients with entecavir. Methods: The levels of LHBs, HBV DNA and HBeAg in 30 patients with chronic hepatitis B treated with antiviral therapy of entecavir were measured at 0 months, 6 months, 12 months, 18 months and 24 months respectively. Results: The positive rate of LHBs was 30.00% (27/30) and the positive rate of HBV-DNA was 100.00% (30/30) in 30 cases of hepatitis B patients (χ2 = 3.16, P> 0.05). The content of LHBs (OD value) was positively correlated with the logarithm of HBV-DNA copy number (r = 0.885). The positive rate of LHBs was significantly higher than that of HBeAg (73.33%) (χ2 = 2.78, P> 0.05). In the entecavir group, the predicted risk of invalidation of antiviral therapy at 0 months, 6 months, 12 months, 18 months and 24 months were 0.28,036,0.46,0.57 and 0.67, respectively. Conclusion: The serum LHBs and HBV-DNA have good consistency, which can be used as a new index to judge the virus replication. The longer the duration of positive LHBs during antiviral therapy, the greater the risk that antiviral therapy will be ineffective.