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目的研究延安地区不同HBV基因型临床特征及其干扰素抗病毒治疗的疗效。方法用PCR的方法鉴定延安地区130例慢性乙型肝炎患者的HBV基因型,并对患者应用α-2b干扰素抗病毒治疗12个月,随访12个月,对治疗及随访资料进行回顾性研究。结果 (1)在延安地区130例慢性乙型肝炎患者中,C基因型98例、15例为B基因型,可见延安地区HBV基因型以B、C基因型为最常见的基因型;(2)B、C、B+C基因型HBeAg阳性率分别为66.7%、82.7%、54.5%,可见B基因型HBeAg阳性率明显低于C基因型,且B+C基因型HBeAg阳性率也明显低于C基因型;(3)B基因型与B+C基因型、B基因型与D基因型、C基因型与D基因型、D基因型与B+C基因型在HBeAg阳性率方面均无显著性差异;(4)B基因型对干扰素的完全应答率、持续应答率明显高于C基因型,而无应答率低于C基因型;(5)B+C基因型的干扰素应答率低于B、C基因型。结论延安地区B、B+C基因型HBeAg阳性率明显低于C基因型;B基因型对干扰素的完全应答率高于C基因型,B+C基因型的干扰素应答率低于B、C基因,提示HBV基因型对优化慢性乙型肝炎抗病毒治疗方案有临床价值。
Objective To investigate the clinical characteristics of different HBV genotypes in Yan’an and the efficacy of interferon antiviral therapy. Methods HBV genotypes of 130 patients with chronic hepatitis B in Yan’an area were identified by PCR. The patients were treated with α-2b interferon for 12 months and followed up for 12 months. The treatment and follow-up data were retrospectively analyzed . Results (1) Among 130 chronic hepatitis B patients in Yan’an district, 98 C genotypes and 15 B genotypes showed that genotypes B and C were the most common genotypes of HBV genotypes in Yan’an. (2) ) The positive rates of HBeAg in B, C and B + C genotypes were 66.7%, 82.7% and 54.5%, respectively. The positive rate of HBeAg in B genotype was significantly lower than that in C genotype, and the positive rate of HBeAg in B + C genotype was also significantly lower In genotype C; (3) There was no HBeAg positive rate between B genotype and B + C genotype, B genotype and D genotype, C genotype and D genotype, D genotype and B + C genotype (4) The complete response rate and continuous response rate of B genotype to interferon were significantly higher than C genotype, but no response rate was lower than C genotype; (5) The B + C genotype IFN response Rate lower than B, C genotype. Conclusion The positive rate of HBeAg of B and B + C genotypes in Yan’an was significantly lower than that of C genotype. The complete response rate of B genotype to interferon was higher than that of C genotype, but the B + C genotype was lower than B, C gene, suggesting that HBV genotypes have clinical value in optimizing antiviral treatment of chronic hepatitis B.