维生素D水平对慢性乙型肝炎抗病毒疗效的预测价值

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摘要目的分析基线维生素D水平对慢性乙型病毒性肝炎病毒学应答的预测价值。方法纳入2017年10月～2019年12月于深圳市第三人民医院住院的115例慢性乙型肝炎患者，根据抗病毒治疗24周乙型肝炎病毒定量（HBV DNA）分为HBV DNA阴性组和HBV DNA阳性组，比较两组患者的临床基线特征，并采Logistic回归分析建立预测模型，以受试者工作特征（ROC）曲线和Hosmer-Lemeshow拟合优度检验作为评估指标。结果抗病毒治疗24周HBV DNA阴性71例（61.74%），阳性44例（38.26%）。基线HBV DNA水平低和维生素D水平高，可获得更好的24周病毒学应答（P＜0.05）。模型一纳入HBV DNA水平和谷丙转氨酶，模型二纳入HBV DNA水平、乙肝表面抗原水平、总胆红素和25羟维生素D。模型一和模型二ROC曲线下面积（AUC）分别为0.735（95%CI：0.639～0.831）和0.810（95%CI：0.732～0.890），两个模型的AUC比较，差异有统计学意义（P=0.039）。结论基于维生素D水平建立的预测模型对慢性乙型肝炎抗病毒治疗24周的病毒学应答具有较好的预测价值。

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	李轩
	张丽娜
	王松
	王方
	何清

关键词 ：维生素D, 25羟维生素D, 慢性乙型肝炎, 预测模型

Abstract：Objective To analyze the predictive value of baseline vitamin D level on the virological response of chronic hepatitis B.Methods A total of 115 inpatients with chronic hepatitis B from October 2017 to December 2019 in the Third People′s Hospital of Shenzhen were included.According to the hepatitis B virus DNA quantitative analysis at treatment week 24,patients were divided into HBV DNA-negative group and HBV DNA-positive group.The clinical baseline characteristics of the two groups were compared.Predictive models were established using multivariate Logistic regression analyses,with the receiver operating characteristic(ROC)curve and the Hosmer-Lemeshow goodness of fit test employed as the evaluation indicators.Results Antiviral treatment for 24 weeks,71 cases(61.74%)and 44 cases(38.26%)were HBV DNA-negative and HBV DNA-positive respectively.With lower HBV DNA level and higher vitamin D level,the 24-week virological outcomes were better(P＜0.05).HBV DNA level and alanine aminotransferase were included in model 1,and HBV DNA level,HBsAg level,total bilirubin,and 25-hydroxy vitamin D were included in model 2.The areas under the ROC curve(AUC)of model 1 and model 2 were 0.735(95%CI:0.639-0.831)and 0.810(95%CI:0.732-0.890)respectively.The AUC of the two models was compared,and the difference was statistically significant(P=0.039).Conclusion The predictive model based on the baseline vitamin D level has a good predictive value for the 24-week virological response in the treatment of chronic hepatitis B.

Key words： Vitamin D 25-hydroxy vitamin D Chronic hepatitis B Predictive model

基金资助:广东省深圳市卫生计生系统科研项目（SZFZ201 7064）；广东省深圳市医学重点学科建设经费项目（SZXK076）

作者简介: 李轩，本科，主治医师，研究方向：传染病学

引用本文:

李轩；张丽娜；王松；王方；何清. 维生素D水平对慢性乙型肝炎抗病毒疗效的预测价值[J]. 中国当代医药, 2021, 28(15): 12-15.
LI Xuan；ZHANG Li-na；WANG Song；WANG Fang；HE Qing. Predictive value of vitamin D level on antiviral efficacy of chronic hepatitis B. 中国当代医药, 2021, 28(15): 12-15.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I15/12

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