摘要
目的:观察乙型肝炎(简称乙肝)患者HBV-DNA载量与血清标志物[乙肝表面抗原(HBsAg)、乙肝病毒e抗原(HBeAg)、乙肝病毒核心抗体(HBcAb)、HBcAb-免疫球蛋白M(IgM)]水平的相关性及其对抗病毒疗效的预测价值.方法:选取2020 年 7 月至 2022 年 7 月该院收治的 154 例乙肝患者进行前瞻性研究,测定其入院时、抗病毒治疗 1 个月后HBV-DNA载量与血清标志物水平.采用Pearson相关性分析,分析乙肝患者入院时HBV-DNA载量与血清标志物水平的相关性;比较抗病毒治疗 6 个月不同疗效患者抗病毒治疗 1 个月时HBV-DNA载量与血清标志物水平;采用受试者工作特征(ROC)曲线分析抗病毒治疗 1 个月HBV-DNA载量与血清标志物水平单项及联合检测对抗病毒治疗 6 个月后疗效的预测价值.结果:Pearson相关性分析结果显示,入院时,乙肝患者HBV-DNA载量与血清HBsAg、HBeAg、HBcAb、HBcAb-IgM水平均呈正相关(r>0,P<0.05);抗病毒治疗 6 个月后完全应答患者治疗 1 个月时HBV-DNA载量和血清HBsAg、HBeAg、HBcAb、HBcAb-IgM水平均低于未完全应答患者,差异有统计学意义(P<0.05);ROC曲线分析结果显示,乙肝患者抗病毒治疗 1 个月后HBV-DNA载量与血清HBsAg、HBeAg、HBcAb、HBcAb-IgM水平联合检测对抗病毒治疗6 个月后的疗效预测价值[曲线下面积(AUC)=0.905]高于五者单项检测(AUC=0.779、0.802、0.792、0.739、0.831).结论:乙肝患者HBV-DNA载量与血清HBsAg、HBeAg、HBcAb、HBcAb-IgM水平均呈正相关,且乙肝患者抗病毒治疗 1 个月后HBV-DNA载量与血清HBsAg、HBeAg、HBcAb、HBcAb-IgM水平联合检测对抗病毒治疗 6 个月后的疗效预测价值高于五者单项检测.
Abstract
Objective:To observe correlations among HBV-DNA load and serum marker[hepatitis B surface antigen(HBsAg),hepatitis B virus e antigen(HBeAg),hepatitis B virus core antibody(HBcAb),HBcAb-immunoglobulin(IgM)]levels in patients with hepatitis B and its predictive value for antiviral efficacy.Methods:A prospective study was conducted on 154 patients with hepatitis B admitted to the hospital from July 2020 to July 2022.The levels of HBV-DNA load and serum markers were measured on admission and 1 month after antiviral treatment.Pearson correlation analysis was used to analyze the correlations among the HBV-DNA load on admission and the serum markers levels in the hepatitis B patients.The levels of HBV-DNA load and serum markers were compared between 6 months of antiviral treatment and 1 month of antiviral treatment.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of single and combined detection of HBV-DNA load and serum markers levels at 1 month after antiviral treatment for 6 months after antiviral treatment.Results:Pearson correlation analysis showed that the HBV-DNA load was positively correlated with the serum HBsAg,HBeAg,HBcAb and HBcAb-IgM levels in the patients with hepatitis B at admission(r>0,P<0.05).The HBV-DNA load and the serum HBsAg,HBeAg,HBcAb and HBcAb-IgM levels in the patients with complete response after 6 months of antiviral treatment were lower than those in the patients with incomplete response at 1 month of treatment,and the differences were statistically significant(P<0.05).ROC curve analysis showed that the predictive value of combined detection of HBV-DNA load and serum HBsAg,HBeAg,HBcAb and HBcAb-IgM levels after 1 month of antiviral treatment in the patients with hepatitis B for 6 months of antiviral treatment[area under the curve(AUC)=0.905]was higher than the predictive value of single detection of the five(AUC=0.779,0.802,0.792,0.739,0.831).Conclusions:The HBV-DNA load in the patients with hepatitis B is positively correlated with the serum HBsAg,HBeAg,HBcAb and HBcAb-IgM levels.Further,the predictive value of combined detection of HBV-DNA load and serum HBsAg,HBeAg,HBcAb and HBcAb-IgM levels in the patients with hepatitis B after 1 month of antiviral treatment was higher than that of single detection of the five for 6 months of antiviral treatment.
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