Low Serum Hepatitis B Surface Antigen Level Predicts Compensated Cirrhosis Caused by Chronic Hepatitis B in HBeAg Positive Patients in East China.
Low Serum Hepatitis B Surface Antigen Level Predicts Compensated Cirrhosis Caused by Chronic Hepatitis B in HBeAg Positive Patients in East China.
复制标题
华东地区HBeAg阳性患者血清乙型肝炎表面抗原水平低预示慢性乙型肝炎引起的代偿性肝硬化
DOI：
10.5812/hepatmon.29183
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发表时间：
2015-08
影响因子：
0.6
通讯作者：
Zhang JM
中科院分区：
文献类型：
--
作者：
Jia W;Qi X;Ji YY;Xun YH;Wang H;Zhang WH;Yang JH;Wang JY;Zhu HX;Mao RC;Zhang JM
背景：血清乙型肝炎表面抗原（HBsAg）水平与慢性乙型肝炎（CHB）感染患者的纤维化相关。目的：我们研究的目的是评估血清 HBsAg 水平作为乙型肝炎 e 抗原 (HBeAg) 阳性 CHB 患者代偿性肝硬化的生物标志物。患者和方法：201 名 HBeAg 阳性的中国慢性乙型肝炎患者（伴或不伴肝硬化）参与了这项回顾性研究。肝硬化是根据肝活检诊断的。此外，失代偿性肝硬化患者被排除在外。对血清 HBsAg 水平与代偿性肝硬化之间的关联进行了统计分析。结果：代偿性肝硬化患者的平均血清 HBsAg 水平显着低于非肝硬化患者（3.27 Log10 IU/mL VS 4.17 Log10 IU/mL，P < 0.001）。此外，检查与代偿性肝硬化的相关性表明，血清 HBsAg 水平较低是多变量分析中的一个重要因素。代偿性肝硬化患者血清HBsAg受试者工作特征曲线下面积为0.856。当血清 HBsAg 的临界值 < 3.60 Log10 IU/mL (4000 IU/mL) 时，获得了 66.2% 的阳性预测值和 90.7% 的阴性预测值。而且，与APRI>2结合后，代偿性肝硬化发生率提高至75.0%。结论：在HBeAg阳性CHB患者中，低血清HBsAg水平是代偿性肝硬化的有用预测因子。
Backgrounds: Serum hepatitis B surface antigen (HBsAg) levels are associated with fibrosis in patients with chronic hepatitis B (CHB) infection. Objectives: The aim of our study was to evaluate serum HBsAg level as a biomarker for compensated cirrhosis in hepatitis B e antigen (HBeAg) positive CHB patients. Patients and Methods: Two-hundred and one HBeAg-positive Chinese CHB patients with or without cirrhosis were enrolled in this retrospective study. Cirrhosis was diagnosed based on liver biopsy. Furthermore, patients with decompensated cirrhosis were excluded. A statistical analysis was performed regarding the association between serum HBsAg level and compensated cirrhosis. Results: Patients with compensated cirrhosis had a significantly lower mean serum HBsAg level compared to those without cirrhosis (3.27 Log10 IU/mL VS 4.17 Log10 IU/mL, P < 0.001). Furthermore, examining the correlation with compensated cirrhosis revealed that lower level of serum HBsAg was a significant factor in multivariate analysis. The area under the receiver operating characteristics curve of serum HBsAg was 0.856 for compensated cirrhosis. A positive predictive value of 66.2% and negative predictive value of 90.7% were obtained with a cut-off value of < 3.60 Log10 IU/mL (4000 IU/mL) of serum HBsAg. Moreover, the rate of compensated cirrhosis increased to 75.0% after combining with APRI > 2. Conclusions: In HBeAg positive CHB patients, low serum HBsAg level is a useful predictor of compensated cirrhosis.