乙型肝炎抗病毒治疗停药后复发与血清HBVDNA水平的相关性分析司慧远，李晓娟，王纯巍，周平(解放军空军总医院，北京100142)［摘耍］目的探讨乙型肝炎(HB)抗病瞬治疗停约后复发与血HBVDNA水平的相关性°方法选取180例接受阿徳福韦酯治疗的HB患者，检测患者治疗前及治疗4周后血清HBVDNA水平。结果HBeAg(+)时，治疗前HBVDNA水平A107copyies/mL复发率是56%,10“〜10copies/mL复发率是36%,＜10r.copies/mL复发率是10%,HBVDNA水平＞107copies/mL停药复发率报高，＜10ficopies/mL报低。治疗4周后，HBVDNA水平＜103copies/mL复发率是18%,较基线下降幅度＞3lgcopics/mL者复发率是20%,较基线下降幅度2Igcopies/mL者复发率是21%,较基线下降幅度1lgcopies/mL者复发率是37%,HBVDNA水平＜10^copies/mL复发率最低较基线下降幅度IIgcopies/mL者复发率最高。HBeAg(-)时.治疗前IIBVDNA水平〉10?copies/mL复发率是27%,106〜10?copies/mL复发率是11%,<106copies/mL复发率是7%,HBVDNA水平〉10?copies/mL停药复发率瑕高。治疗4周后，HBVDNA水平＜l(hcopies/mL复发率是6%,较基线下降幅度＞3Igcopies/tnL者复发率是10%,较基线下降幅度2lgcopics/mL者复发率是11%,较基线卜降幅度1Igcopies/mL者复发率是63%,HBVDNA水平＜10copies/'mL复发率最低。较基线F降幅度1lg-copies/mL者复发率故高。结论HB患者抗病毒治疗停药后复发和患者治疗前的血清HBVDNA水平、治疗早期HBVDNA水平及血清HBVDNA水平降幅存在相关性。［关键词］乙型肝炎；复发；HBVDNA：抗病毒doi：10.3969/j・issn.100X—S849.2014.03.008［］R512.62［文献标识码］A［］1008—8849(2014)03一0248一03CorrelationanalysisbetweenrecurrenceafterantiviraltreatmentofhepatitisBstoppedandserumHBVDNAlevelSiHuiyuan,LiXiaojuan.WangChunwci,ZhouPing(AirForceGeneralHospitalofPLA,Beijing100142.China)Abstract：ObjectiveItistoapproachthecorrelationbetweenrecurrenceafterantiviraltreatmentofhepatitisBstoppedandserumHBVDNAlevel.Methods180hepatitisBpatientstreatedwithAdefovirDipivoxilwereselectedtthesemmHBVDNAlevelsofthemweredetectedbeforetreatmentand4weeksaftertreatment.ResultsAsHBeAg(+〉，beforetreatmentstherecurrenceratewas56%forHBVDNAlevel>10?copies/mL,36%CorHBVDNAlevelsfrom1()6to10?copies/mL,and10%forHBVDNAlevels<106copies/mL,therecurrencerateof!IBVDNAlevels>10?copies/mLwashighest,<106copies/mLwaslowest.After4weekstreatmentstherecurrenceratewas18%forHBVDNAlevel<10scopiesimL,20%fordown>3Igcopies/mLcomparedwithbaseline,21%fordrop2Igcopies/mL.37%fordropIIgcopies/mL,there-currencerateofHBVDNAlevel<103copies/mLwaslowest,dropIlgcopies/mLwashighest.AsHBeAg(—),beforetreatment,therecurrenceratewas27%forHBVDNAlevel>10?copies/mL,11%forHBVDNAlevelfrom106to107copies/rnLrand7%forHBVDNAlevel<l()6copies/mL,therecurrencerateofHBVDNAlevel>10?copies/mLwashighest・after4weekstreatment,therecurrenceratewas6%torHB\TDNAlevel<10>copies/mL,10%forDown>3lgcopies/mLcomparedwithbaseline.11%fordrop2Igcopies/mLr23%forIIgcopies/mL,therecurrencerateHBVDNAlevel<10acopies/mLwaslowest»dropIIgcopiesimLwashighest.ConclusionHepatitisBrecurrenceafterdiscontinuationofantiviraltherapyinpatientsiscorrelatedwiththeserumHBVDNAlevelsbeforetreatment,earlyHB\TDNAlevelaftertreatmentanddecreasingamplitudeofthescrumHBVDNAlevelsaftertreatment・Keywords：hepatitisB：recurrence；HBVDNA：antiviraltreatment〔作者简介］司惡远.男.主治医师•研究方向为慢性肝灸的抗乙型肝炎"HB)全球发衲率很口.fW在区域弟别。90%病帝治疗和不期原因发热的诊断和鉴别诊断。［通信作者］周平,Tel:15611161138急性HB可自愈，而慢性HB则结局不尽相同，预后也较差。HB发病主要和患者免疫力强弱相关，免疫力较强者由于其宿主免疫应答反应较强烈，可表现为急性HB,预后比较好，而免疫力较...