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目的分析并探讨HBeAg检测在乙型肝炎患者抗病毒治疗中的价值。方法选取乙型肝炎患者160例,随机分为观察组和对照组各80例。采用荧光定量法检测乙型肝炎患者HBV DNA水平;观察组80例除测定HBV DNA水平外,采用免疫化学发光法检测乙型肝炎患者抗病毒治疗过程中的HBeAg水平变化,在使用替比夫定(LDT)抗病毒治疗的过程中,于治疗3个月、6个月、9个月、12个月分别测定,探讨HBeAg检测在治疗过程中的指导意义。结果在治疗12个月后,观察组HBV DNA完全转阴63例(79%),HBeAg转阴26例(32%),其HBeAg和HBV DNA水平呈同步下降趋势;治疗无效的患者12例,其血清HBV DNA和HBeAg水平也存在下降趋势,但未转阴;5例HBV DNA短暂转阴的患者,在治疗6个月后又转为阳性,而HBeAg并未转阴。对照组HBV DNA完全转阴60例(75%),治疗无效患者13例,其HBeAg和HBV DNA水平同观察组相比无显著性差异。结论在使用替比夫定对乙型肝炎患者进行抗病毒治疗的过程中,HBeAg的动态检测结果和HBV DNA检测结果可用于评估药物的抗病毒效果,且二者效果一致。可进行下一步研究以确定其作为治疗控制指标的可行性。
Objective To analyze and discuss the value of HBeAg detection in antiviral treatment of hepatitis B patients. Methods Totally 160 patients with hepatitis B were randomly divided into observation group and control group, 80 cases each. The level of HBV DNA in hepatitis B patients was detected by fluorescence quantitative assay. In addition to the determination of HBV DNA level in 80 cases in observation group, the changes of HBeAg levels in hepatitis B patients during antiviral therapy were detected by immunochemical chemiluminescence. (LDT) antiviral therapy in the treatment of 3 months, 6 months, 9 months, 12 months were measured to explore the significance of HBeAg detection in the course of treatment. Results After 12 months of treatment, the HBV DNA level in the observation group was completely negative in 63 (79%) and in 26 (32%) patients with negative HBeAg. The levels of HBeAg and HBV DNA showed a synchronous decrease trend. In the 12 patients with ineffective treatment, Serum HBV DNA and HBeAg levels also showed a downward trend, but not negative; 5 cases of transient HBV DNA negative patients in the treatment of 6 months later turned positive, and HBeAg did not turn negative. Control group HBV DNA completely negative in 60 cases (75%), 13 cases of ineffective treatment, the HBeAg and HBV DNA levels compared with the observation group was no significant difference. Conclusions During the antiretroviral treatment of hepatitis B patients with telbivudine, the results of dynamic detection of HBeAg and HBV DNA test results can be used to evaluate the antiviral effect of the drug, and the results are consistent. The next step can be done to determine its feasibility as a control indicator of treatment.