针对HBV RNA优化的慢性乙型肝炎临床治疗的效果评价

摘要/Abstract

摘要： 目的探讨在慢性乙型肝炎的临床治疗过程中,在患者血清HBV DNA转阴后,针对HBV RNA进行治疗的效果,并通过与传统方式治疗患者血清学标志物进行比较,分析该治疗方式的可行性。方法本研究共纳入2017年1月—2023年5月期间山东省济南市传染病医院与山东省第三人民医院收治的慢性乙型肝炎患者118例,前期使用恩替卡韦治疗,待患者血清HBV DNA转阴后,对照组继续使用恩替卡韦治疗,实验组增加聚乙二醇化干扰素α-2b治疗。分别收集患者不同治疗阶段的血清标志物数据,通过比较实验组对照组患者血清HBsAg和HBeAg变化量和转阴率,比较不同治疗方法的效果。结果实验组患者血清HBsAg和HBeAg在治疗各个时期的月均下降量均高于对照组,并且患者在治疗结束后,血清HBsAg和HBeAg下降率高于对照组。实验组患者在接受干扰素治疗1个月时血清HBsAg下降191.8 IU/mL,血清HBeAg下降8.39 COI,治疗3个月时血清HBsAg月均下降110.9 IU/mL,血清HBeAg月均下降2.61 COI,速度快于对照组(P<0.05),治疗48周后实验组HBsAg转阴率为14.7%,HBeAg转阴率为27.8%,实验组转阴率高于对照组(P<0.05)。结论在慢性乙型肝炎治疗过程中,HBV RNA与HBV DNA同样是值得关注的治疗指标。患者血清HBV DNA转阴后针对HBV RNA进行治疗,可明显降低患者血清HBsAg和HBeAg水平,部分患者可达到临床治愈要求。

关键词: 慢性乙型肝炎, 乙型肝炎病毒RNA, 乙型肝炎表面抗原, 乙型肝炎e抗原, 恩替卡韦, 聚乙二醇化干扰素α-2b

Abstract: Objective To explore the effect of HBV RNA optimized therapy in the clinical treatment of chronic hepatitis B patients after HBV DNA serum disappearance, and to analyze the feasibility of this treatment by comparing with the serological markers of patients received traditional treatment. Methods A total of 118 patients with chronic hepatitis B were included in this study. They were treated with entecavir in early stage. After the patients' serum HBV DNA turned negative, the control group was continuously treated with entecavir, and the experimental group was treated with PEG-interferon α-2b. The data of serum makers in different treatment stages were collected, and the effects of different treatment methods were compared by comparing the alteration and negative conversion rates of HBsAg and HBeAg between the two groups. Results The monthly average decrease in serum HBsAg and HBeAg levels of patients in the experimental group were higher than those in the control group during each treatment period, and the decrease rates were higher than those in the control group after treatment. After 1 month of interferon treatment in the experimental group of patients, the serum HBsAg and HBeAg decreased by 191.8 IU/mL and 8.39 COI, respectively. After 3 months of treatment, the serum HBsAg and HBeAg decreased by 110.9 IU/mL and 2.61 COI, respectively, with faster rates than those of the control group (P<0.05). After 48 weeks of treatment, the HBsAg and HBeAg conversion rates in the experimental group were 14.7% and 27.8%, respectively, which were higher than those of the control group (P<0.05). Conclusion In the treatment of chronic hepatitis B, HBV RNA as well as HBV DNA are therapeutic indicators that are worthy of attention. The levels of serum HBsAg and HBeAg can be significantly reduced by treating HBV RNA when HBV DNA has turned negative, and some patients can reach the requirement of clinical cure.

Key words: Chronic hepatitis B, Hepatitis B virus RNA, Hepatitis B surface antigen, Hepatitis B e antigen, Entecavir, Pegylated interferon α-2b

彭敏, 阚君泽, 高卉, 阚晓. 针对HBV RNA优化的慢性乙型肝炎临床治疗的效果评价[J]. 肝脏, 2025, 30(2): 170-174.

PENG Min, KAN Jun-ze, GAO Hui, KAN Xiao. An evaluation of the clinical treatment effect on chronic hepatitis B optimized for HBV RNA[J]. Chinese Hepatolgy, 2025, 30(2): 170-174.

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