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目的观察HBe Ag阴性慢性乙型肝炎患者核苷(酸)类似物(NUCs)停药后病情复发情况,分析相关因素。方法选择2011年6月—2015年6月在太仓市第一人民医院和苏州市第五人民医院住院及门诊服用NUCs停药后复发的HBe Ag阴性慢性乙型肝炎患者39例,分为规范停药后复发组(A组)16例和不规范停药后复发组(B组)23例。另外选择同期服用NUCs停药后1年内未复发的HBe Ag阴性慢性乙型肝炎患者9例作为未复发组。分析停药后1年内肝炎复发情况和相关因素。结果未复发组患者基线血清HBV DNA低于A、B组,差异有统计学意义(P<0.05),A组基线血清HBV DNA与B组比较,差异无统计学意义(P>0.05);未复发组患者基线血清HBs Ag水平低于B组,差异有统计学意义(P<0.05),但与A组比较,差异无统计学意义(P>0.05);未复发组患者停药时血清HBs Ag水平低于A、B组,差异有统计学意义(P<0.05),A组停药时血清HBs Ag水平与B组比较,差异无统计学意义(P>0.05)。结论 HBe Ag阴性慢性乙型肝炎患者服用NUCs规范停药或不规范停药后1年内均有复发,不规范停药后6个月以内复发率较高,患者基线血清HBV DNA水平、基线血清HBs Ag或停药时血清HBs Ag水平与复发可能有关。
Objective To observe the recurrence of nucleoside analogues (NUCs) in patients with HBe Ag-negative chronic hepatitis B and to analyze the related factors. Methods Thirty-nine patients with HBeAg-negative chronic hepatitis B who were hospitalized and outpatient after NUCs withdrawal from June 2011 to June 2015 in Taicang First People’s Hospital and Suzhou Fifth People’s Hospital were divided into standard stop There were 16 cases in the relapsed group (group A) and 23 cases in the non-standard group (group B). In addition, 9 patients with HBeAg-negative chronic hepatitis B who did not relapse within 1 year after taking NUCs during the same period were selected as the non-relapse patients. Hepatitis recurrence and related factors within 1 year after discontinuation were analyzed. Results The baseline serum HBV DNA of patients without recurrence was lower than that of patients with A and B (P <0.05). There was no significant difference between baseline HBV DNA of group A and B (P> 0.05) The baseline serum HBsAg level in relapse group was lower than that in group B, the difference was statistically significant (P <0.05), but there was no significant difference compared with group A (P> 0.05) (P <0.05). There was no significant difference in serum HBsAg level between group A and group B (P> 0.05). Conclusions Patients with HBe Ag-negative chronic hepatitis B relapse within 1 year after taking NUCs regimen or without standard treatment, and have a higher relapse rate within 6 months after stopping non-standard treatment. The baseline serum HBV DNA level, baseline serum HBs Ag or serum HBsAg levels may be related to relapse.