实用医学杂志 ›› 2022, Vol. 38 ›› Issue (20): 2585-2596.doi: 10.3969/j.issn.1006⁃5725.2022.20.014

• 药物与临床 • 上一篇    下一篇

HBV pgRNA表达水平与慢性乙型肝炎患者核(苷)酸类似物治疗反应性的相关性 

  

  1. 朱雪丽 林照坤 王丽芸 海南医学院第一附属医院感染科(海口 570102

  • 出版日期:2022-10-25 发布日期:2022-10-25
  • 基金资助:
    海南省卫生健康行业科研项目(编号:19A200504)

Correlation between HBV pgRNA expression level andresponsiveness to nucleoside analog therapy in pa⁃ tients with chronic hepatitis B

ZHU XueliLIN ZhaokunWANG Liyun.   

  1. Department of Infectious Diseasesthe First Affiliated Hospital of Hainan Medical CollegeHaikou 570102China

  • Online:2022-10-25 Published:2022-10-25

摘要:

目的 探讨 HBV pgRNA 表达水平与慢性乙型肝炎(CHB)患者核(苷)酸类似物(NAs)治疗 反应性的相关性。方法 选择 2020 1 月至 2021 6 月在我院门诊确诊的 CHB 患者 237 例作为研究对 象,所有患者均达到 NAs 治疗标准。治疗前所有患者均完善 HBV pgRNA 检查,并收集患者一般资料、实 验室检查资料及影像学检查资料。分别予以 NAs 相关药物进行为期 24 周的治疗方案,于治疗结束后统计治疗周期间患者的治疗反应,并进行分组。通过 logistic 回归分析治疗反应与 HBV pgRNA 之间的相关性, 并建立 ROC 曲线分析 HBV pgRNA 对治疗反应的预测价值。结果 截止 2021 12 月所有患者治疗期满, 共计 207 例患者完成本次研究规定的治疗及随访方案,完成率为 87.34%。分组为完全应答(n = 87)、部分应答(n = 79)及应答不佳(n = 41)。三组间一般资料比较差异无统计学意义(P > 0.05)。三组患者间HBV⁃ DNAHBV pgRNAHBsAgHBeAg HBeAb 差异有统计学意义(P < 0.05)。应答不佳组患者 HBV⁃DNAHBV pgRNAHBsAgHBeAg 均高于其他两组,而 HBeAb 低于其他两组,差异有统计学意义(P < 0.05)。部分应答组 HBV pgRNA 高于完全应答组,差异有统计学意义(P < 0.05)。部分应答组和完全应答组患者 HBV⁃DNAHBsAgHBeAg HBeAb 比较差异无统计学意义(P > 0.05)。HBV⁃DNAHBV pgRNAHBsAgHBeAg是影响治疗反应的独立危险因素,而HBeAb是影响治疗反应的独立保护因素(P < 0.05)。HBV pgRNA NAs 治疗反应预测的 AUC 明显优于 HBV⁃DNAHBsAgHBeAgHBeAbP < 0.05)。结论 HBV pgRNA CHB 患者NAs 治疗后反应显著相关。

关键词:

慢性乙型肝炎, 核苷酸类似物, HBV 前基因组RNA, 相关性分析

Abstract:

Objective To investigate the correlation between the expression level of HBV pgRNA and the responsiveness to nucleoside analogsNAsin patients with chronic hepatitis BCHB. Methods A total of 237 CHB patients diagnosed in the outpatient department of our hospital from January 2020 to June 2021 were selected as the research subjects. All patients met the NAs treatment standard. Before treatmentall patients were tested for HBV pgRNAand the general datalaboratory data and imaging data were collected. NAs ⁃ related drugs were administered for a 24⁃week treatment plan. The treatment response of the patients during the treatment was counted and grouped at the end of the treatment. logistic regression was used to analyze the correlation between treatment response and HBV pgRNAand ROC curve was drawn to analyze the predictive value of HBV pgRNA for treat⁃ ment response. Results As of December 2021the treatment period of all patients had expiredand a total of 207 patients had completed the treatment and follow⁃up plan prescribed in this studywith a completion rate of 87.34%. Patients were divided into complete response groupn = 87),partial response groupn = 79),and poor response groupn = 41. There was no statistically significant difference in general data among the three groupsP > 0.05. There were significant differences in HBV ⁃ DNAHBV pgRNAHBsAgHBeAg and HBeAb among the three groupsP < 0.05. The HBV⁃DNAHBV pgRNAHBsAgand HBeAg in the poor response group were higher than those in the other two groupsbut HBeAb was lowerand the difference was statistically significantP < 0.05. The HBV pgRNA in the partial response group was higher than that in the complete response groupand the differ⁃ ence was statistically significantP < 0.05. There was no significant difference in HBV ⁃DNAHBsAgHBeAg and HBeAb between the partial response group and the complete response groupP > 0.05. HBV ⁃DNAHBVpgRNAHBsAg and HBeAg were independent risk factors for treatment responsewhile HBeAb was an indepen⁃ dent protective factor for treatment responseP < 0.05. The AUC of HBV pgRNA in response to NAs treatment was significantly bigger than that of HBV ⁃DNAHBsAgHBeAgand HBeAbP < 0.05. Conclusion HBV pgRNA is significantly correlated with the response to NAs treatment in CHB patients. 

Key words:

chronic hepatitis B, nucleotide analogs, HBV pre?genomic RNA, correlation analysis