南方医科大学学报

南方医科大学学报 ›› 2022, Vol. 42 ›› Issue (8): 1250-1255.doi: 10.12122/j.issn.1673-4254.2022.08.19

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血清HBV RNA预测恩替卡韦治疗慢性乙型肝炎患者疗效的价值

朱 莹，罗园香，郭凤霞，杨可立，范慧敏，刘翠珏，黄 波，唐小平，关玉娟   

  1. 广州医科大学附属市八医院肝病中心，广东 广州 510060，广州海力特生物科技有限公司，广东 广州 510530
  • 出版日期:2022-08-20 发布日期:2022-09-05

Predictive value of serum HBV RNA for therapeutic effect of entecavir in patients with chronic hepatitis B

ZHU Ying, LUO Yuanxiang, GUO Fengxia, YANG Keli, FAN Huimin, LIU Cuijue, HUANG Bo, TANG Xiaoping, GUAN Yujuan   

  1. Department of Hepatology, Guangzhou Eighth People's Hospital Affiliated to Guangzhou Medical University, Guangzhou 510060, China; Guangzhou Hailite Biotechnoloty Co.Ltd, Guangzhou 510530, China
  • Online:2022-08-20 Published:2022-09-05

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摘要： 目的 探讨HBV RNA在乙肝抗病毒治疗过程中可能存在的预测价值。方法 研究59例恩替卡韦（ETV）治疗96月（或108月）的慢性乙型肝炎（CHB）患者的血清样本。在基线、3月、6月、9月、12月、36月、72月和96月（或108月）时检测HBV RNA水平、HBV DNA水平和血清学指标（HBeAg）。结果 在接受ETV抗病毒治疗12月、36月后，HBV RNA虽然有所下降，但HBV RNA转阴率变化无统计学意义（P>0.05），治疗72月后，甚至96（或108）月时，有33例患者的HBV RNA水平低于100 copies/mL，其中29例患者的HBV RNA低于检测下限，HBV RNA转阴率差异有统计学意义（P<0.05）。HBV RNA水平越低，HBeAg转阴率越高（P<0.05），年龄、HBV RNA与HBeAg转阴率呈正相关（P<0.05）。结论 随着ETV抗病毒治疗时间延长，HBV RNA的清除越彻底，其转阴率越高。本研究证实抗病毒时间、年龄与HBV RNA转阴率呈正相关，越早抗病毒治疗效果越好。HBV RNA可作为ETV治疗预测HBeAg是否转阴的指标。

关键词: HBV RNA；疗效；预测价值；恩替卡韦

Abstract: Objective To investigate the value of HBV RNA for predicting the therapeutic effect of long- term entecavir (ETV) antiviral therapy in patients with chronic hepatitis B (CHB). Methods Serum samples were collected from 59 CHB patients treated with ETV for 96 or 108 months. HBV RNA levels, HBV DNA levels, and serological marker (HBeAg) levels were measured at baseline and 3, 6, 9, 12, 36, 72, and 96 (or 108) months during the therapy. Results Although HBV RNA level decreased after 12 and 36 months of ETV antiviral therapy, no significance changes occurred in HBV RNA negative conversion rate (P>0.05). After 72 months of treatment or longer, 33 patients had HBV RNA levels lower than 100 copies/mL, and among them 29 patients had HBV RNA levels lower than the detection limit, and HBV RNA negative conversion rate was statistically significant (P<0.05). A lower HBV RNA level was associated with a higher HBeAg negative conversion rate (P<0.05). Age and HBV RNA level were positively correlated with HBeAg negative conversion rate (P<0.05). Conclusion Prolonged ETV antiviral therapy results in better clearance of HBV RNA and a higher negative conversion rate in CHB patients. The length of antiviral therapy and age are positively correlated with the negative conversion rate of HBV RNA, and earlier administration of the antiviral treatment achieves better therapeutic effect. Serum HBV RNA level can be used as an indicator for predicting conversion to negative HBeAg in CHB patients receiving ETV therapy

Key words: HBV RNA; efficacy; predictive value; entecavir