慢性乙型肝炎免疫清除期甲胎蛋白与HBV DNA清除的相关性研究-论文.pdf

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1、65·临床论著·慢性乙型肝炎免疫清除期甲胎蛋白与HBVDNA清除的相关性研究庞晓鹰徐洪涛杨秀珍成建春沈美龙【摘要】目的探讨乙型肝炎免疫清除期，甲胎蛋白(AFP)与HBVDNA清除之间的相关性。方法收集处t免疫清除期发病2周内AFP升高5倍以上患者共58例，分为非抗病毒治疗组(下称观察组)3l例和核苷(酸)类似物抗病毒治疗组(下称阳性对照组)27例，另取同期住院AFP阴性首次发病的慢性乙型肝炎核苷(酸)类似物抗病毒患者30例作为阴性对照组。分析影响HBVDNA清除率的相关素。结果阳性对照组及阴性对照组患者均行抗病毒治疗，HBVDNA定量与各临床数据之问均尤相关性，观察组H

2、BVDNA定量与各指标之间的关系结果显示，AFP与HBVDNA清除具有显著相关性(r=0．8420，P=0．0l8)，以下依次为ALT(r=0．7888，P=0．027)和总胆红素(TBil)(，=0．7816，P：0．032)。HBsAg(r=0．0480，P=0．413)和HBeAg(，=0．3356，P=0．191)与HBVDNA清除无显著相关性。结论对乙型肝炎免疫清除期AFP升高5倍以上患者，可先进行密切病情察，根据病情需要进行抗病毒治疗。【关键词】盯炎，乙型，慢性；免疫清除期；甲胎蛋白；HBVDNACorrelationbetweenserumalpha—fe

3、toproteinlevelandHBVDNAclearanceinimmuneclearancephaseofpatientswithchronichepatitisBPANGXiaoying,XUHongtaoYANGXiuzhen，XIANJianchun，SHENMeilong．DepartmengofLiverDiseasesofTaizhouPeopleHospital,Ta&hou225300,ChinaCorrespondingauthor：SHENMeilong,Email：shenm19326@126．com【Abstract]ObjectivesT

4、oinvestigatetherelationshipbetweenserumalpha—fetoproteinlevelandHBVDNAclearanceinimmuneclearancephaseofpatientswithchronichepatitisB(CHB)．MethodsTotalof58caseswithCHB．whowereinimmuneclearancephaseandtheserumalpha—fetoproteinlevel>5upperlimitsofnormalintwoweekssincediseaseonsetwereenrolle

5、d．Amongwhich31casesreceivednon—antiviraltherapyasexperimentalgroup，and27casesreceivedantiviraltherapyaspositivecontrolgroup．Whileother30caseswithCHBwhowereinimmuneclearancephaseandtheserumalpha—fetoproteinlevelwerenormalintwoweekssincediseaseonset，wereenrolledasnegativecontrolgroup．Andth

6、ecorrelationfactorsofHBVDNAclearancewereanalyzed，respectively．ResultsTherewerenosignificantcorelationbetweenHBVDNAclearanceandotherdatainpatientswhoreceivedantiviraltherapyinpositiveandnegativecontrolgroup．Inexperimentalgroup，therewerepositivecorrelationbetweenHBVDNAclearanceandserumalph

7、a—fetoproteinlevel(r=0．8420，P=0．018)，andintumwerealanineaminotransferase=0．7888，尸=0．027)，totalbilirubin(TBil)(，=0．7816，P=0．032)，buttherewerenosignificantcorrelationamongHBVDNAclearancewithHBsAg=0．0480，尸=0．413)andHBeAg0．3356，尸0．191)．ConclusionsPatientswithCHBwhowereinimmun