替比夫定治疗HBeAg阳性慢性乙型肝炎的疗效及相关预测因子的Logistic回归分析

郭如意; 余雪平; 苏智军; 林成祖; 林志鹏; 林琪

替比夫定治疗HBeAg阳性慢性乙型肝炎的疗效及相关预测因子的Logistic回归分析

福建医科大学附属泉州第一医院感染科

基金项目:

2008年泉州市科技计划项目(2008Z36)；

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中图分类号: R512.62
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出版历程
- 出版日期: 2013-02-20

Evaluation of telbivudine’s efficacy for treating HBeAg-positive chronic B hepatitis patients and identification of its predictive factors by logistic regression analysis

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摘要

摘要:
目的观察替比夫定(LdT)治疗HBeAg阳性慢性乙型肝炎(CHB)患者3年的疗效,应用Logistic回归探讨HBeAg血清学转换的预测因子。方法收集58例采用LdT治疗的HBeAg阳性CHB患者,分析其性别、年龄、基线ALT水平、基线HBV DNA载量、基线HBeAg和HBsAg滴度与治疗3年时ALT复常率、HBV DNA阴转率、HBeAg阴转率和HBeAg血清转换率的相关性;采用Logistic回归分析HBeAg血清转换的相关因素。结果治疗3年时ALT复常率为84.48%,HBV DNA阴转率为70.69%,HBeAg阴转率为50.00%,HBeAg血清转换率为43.10%。与ALT≤2倍正常值上限(2×ULN)相比,基线ALT>5×ULN的患者HBeAg转换率显著增高(P<0.05);与hbeag≤100(s hbeag="">200 S/CO的患者HBeAg的阴转率和血清转换率均显著下降(P<0.05);与hbv 6="" hbv="" dna="">7 log拷贝/ml的患者HBV DNA转阴率、HBeAg转阴率和HBe...
- 肝炎,乙型,慢性 /
- 肝炎e抗原,乙型 /
- 替比夫定
Abstract:
Objective To evaluate the efficacy of a 36-month telbivudine (LdT) treatment regimen in patients with hepatitis B e antigen (HBeAg) -positive chronic hepatitis B (CHB) and to explore the predictive factors of LdT-induced HBeAg seroconversion using logistic regression analysis.Methods A total of 58 HBeAg-positive CHB patients treated with LdT continuously for 36 months were analyzed to determine any potential correlations between sex, age, baseline levels of alanine aminotransferase (ALT) , HBV DNA load, HBeAg titer, or hepatitis B surface antigen (HBsAg) titer and end-of-treatment rates of ALT normalization, undetectable HBV DNA, HBeAg clearance, or HBeAg seroconversion.The factors capable of predicting HBeAg seroconversion were identified by logistic regression analysis.Results After 36 months of LdT treatment, the ALT normalization rate was 84.48%, the undetectable HBV DNA rate was 70.69%, the HBeAg clearance rate was 50.0%, and the HBeAg seroconversion rate was 43.1%.The undetectable HBV DNA rate was significantly correlated to baseline HBV DNA load (P<0.05) .The HBeAg clearance rate was significantly correlated to baseline HBeAg titers and HBV DNA load (P<0.05) .The HBeAg seroconversion rate was significantly correlated to baseline ALT, HBeAg titers, and HBV DNA load (P<0.05) all="" of="" these="" indicators="" were="" unrelated="" to="" or="" baseline="" hbsag="" titers="" p="">0.05) .Multivariate logistic regression analysis showed that only the patients with lower baseline HBeAg titer were more likely to develop HBeAg seroconversion.Conclusion Continuous LdT treatment over 36 months can effectively improve liver function, suppress HBV replication, and increase the HBeAg seroconversion rate.Baseline HBeAg titer may be a useful predictive factor of the HBeAg seroconversion rate in HBeAg-positive CHB patients who are treated with LdT.
- hepatitis B /
- chronic /
- hepatitis B e antigen

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参考文献(10)

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