不同抗病毒方案治疗乙型肝炎表面抗原和抗体双阳性慢性乙型肝炎患者的临床疗效及转归分析

摘要/Abstract

摘要： 目的分析不同抗病毒方案治疗乙型肝炎表面抗原(HBsAg)和抗体(抗-HBs)双阳性慢性乙型肝炎患者(CHB)的临床疗效及转归。方法 2020年2月—2023年6月南京医科大学附属江苏盛泽医院收治的HBsAg和抗-HBs双阳性CHB患者65例,根据患者的治疗方式不同分为干扰素组(n=30)和恩替卡韦组(n=35)。比较两组临床疗效及转归。结果恩替卡韦组的HBeAg下降幅度、HBeAg转阴率、丙氨酸氨基转移酶复常率分别为(1.29±0.65)PEIU/mL、85.7%、85.7%,均优于干扰素组[(0.96±0.36)PEIU/mL、33.3%、43.3%];干扰素组的抗-HBe下降幅度、HBV DNA下降幅度、HBV DNA转阴率分别为(0.15±0.03)PEIU/mL、(4.27±2.10)U/mL、83.3%,均优于恩替卡韦组[(0.06±0.02)PEIU/mL、(3.12±1.12)U/mL、57.1%,P<0.05];经治疗后,干扰素组的HBeAg转阴、抗-HBe阳性的占比为83.3%,明显高于恩替卡韦组[42.9%,P<0.05]。结论采取抗病毒治疗HBsAg和抗-HBs双阳性CHB患者是最有效的措施,尤其是干扰素治疗,是提高治疗率的关键。

关键词: 抗病毒治疗, 乙型肝炎表面抗原, 乙型肝炎表面抗体, 慢性乙型肝炎, 干扰素

Abstract: Objective To analyze the clinical efficacy and outcome of chronic hepatitis B patients with double-positive hepatitis B virus surface antigen and antibody treated with different antiviral regimens.Methods Sixty-five chronic hepatitis B patients with double-positive hepatitis B virus surface antigen and antibody admitted to Jiangsu Shengze Hospital Affiliated to Nanjing Medical University between February 2020 and June 2023 were divided into an interferon group (n=30) and an entecavir group (n=35) according to the patients' treatment modality. The clinical efficacy and outcome of the two groups were compared.Results In the entecavir combined with interferon group, the decrease in hepatitis B e antigen, the rate of hepatitis B e antigen reversion, and the rate of glutamate reversion were (1.29±0.65) PEIU/mL, 85.7%, and 85.7%, respectively, which were better than those of (0.96±0.36) PEIU/mL, 33.3%, and 43.3% in the interferon group; the decrease in hepatitis B e antibody, the decrease in hepatitis B virus deoxyribonucleic acid (DNA), and the rate of hepatitis B virus DNA reversion in the interferon group were (0.15±0.03) PEIU/mL, (4.27±2.10) U/mL and 83.3%, respectively, which were better than those of (0.06±0.02) PEIU/mL, (3.12±1.12) U/mL and 57.1% in the entecavir combined with interferon group (P<0.05); After treatment, the percentage of hepatitis B e antigen conversion and hepatitis B e antibody positivity in the interferon group was 83.3%, which was significantly higher than that of 42.9% in the entecavir combined with interferon group (P<0.05).Conclusion Treating chronic hepatitis B patients who are double positive for hepatitis B virus surface antigen and antibody with antiviral regimens, especially interferon therapy, is the key to improve the effective rate.

Key words: Antiviral therapy, Hepatitis B surface antigen, Anti-hepatitis B, Chronic hepatitis B

杨熹, 葛军, 徐晨阳, 颜雪方. 不同抗病毒方案治疗乙型肝炎表面抗原和抗体双阳性慢性乙型肝炎患者的临床疗效及转归分析[J]. 肝脏, 2024, 29(12): 1468-1471.

YANG Xi, GE Jun, XU Chen-yang, YAN Xue-fang. An analysis on the clinical efficacy and outcome of chronic hepatitis B patients with double-positive hepatitis B virus surface antigen and antibody treated with different antiviral regimens[J]. Chinese Hepatolgy, 2024, 29(12): 1468-1471.

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