AIM: Predictive value of serum b2-microglobulin (b2m)levels for virological breakthrough (VB) in HBeAg-negative chronic hepatitis B (CHB) patients under long-term treatment schedules including lamivudine (LAM).METHODS...AIM: Predictive value of serum b2-microglobulin (b2m)levels for virological breakthrough (VB) in HBeAg-negative chronic hepatitis B (CHB) patients under long-term treatment schedules including lamivudine (LAM).METHODS: Serum b2m levels were calculated during treatment in 25 CHB patients under long-term LAM monotherapy (group A) and 12 patients under initial interferon plus LAM treatment followed by LAM monotherapy (group B), using the MEIA technology. We used Cox proportional hazard models in order to investigate the association between serum b2m levels and VB.RESULTS: Seven of 25 patients (28%), 9/25 (36%) and 14/25 (56%) from group A and 0/12, 2/12 (16.6%) and 3/12 (25%) from group B exhibited VB at months 12, 24 and 36 of treatment, respectively. All patients, from both groups, who did not show VB exhibited b2m elevation in mo 3. The duration of b2m elevation was significantly longer in the virological responder's subgroup from group A than the non-responder's one (7.3±2.6 vs 3.8±3.4 mo,P = 0.02). In comparison to group A patients whose b2m levels were increased at 3 mo, patients whose b2m levels were decreased had 4.6 times higher risk of experiencing VB (RR = 4.6, P = 0.024). When baseline variables were simultaneously included in the same Cox model, decreased b2m status was still associated with increased risk of VB (RR = 12.2, P = 0.03).CONCLUSION: In HBeAg-negative CHB patients under either long-term LAM monotherapy or initial combination treatment, serum b2m levels at 3 mo of treatment,compared to baseline ones, might be a predictor of risk for VB.展开更多
目的讨论血清前B细胞克隆增强因子(pre-B cell colony-enhancing factor,PBEF)、Kruppel样转录因子2(kruppel like factor 2,KLF2)、白介素-26(Interleukin-26,IL-26)与重症肺炎(severe pneumonia,SP)患儿病情严重程度及预后转归的关系...目的讨论血清前B细胞克隆增强因子(pre-B cell colony-enhancing factor,PBEF)、Kruppel样转录因子2(kruppel like factor 2,KLF2)、白介素-26(Interleukin-26,IL-26)与重症肺炎(severe pneumonia,SP)患儿病情严重程度及预后转归的关系。方法选择西安市儿童医院2023年3月-2025年3月收治的180例SP患儿作为研究对象,使用ELISA试剂盒分别检测血清中PBEF、KLF2、IL-26的蛋白水平;根据急性生理与慢性健康评分II(acute physiology and chronic health score,APACHEII评分)判定患儿的病情严重程度并分组为非危重症组(n=60)、危重症组(n=75)和极危重症组(n=45);根据SP患儿预后分为预后良好组(n=127)和预后不良组(n=53);血清PBEF、KLF2、IL-26水平与APACHEII评分的相关性采用Pearson法分析;多因素Logistics回归分析影响SP患儿预后转归的因素;ROC曲线分析血清PBEF、KLF2、IL-26水平对SP患儿预后转归的预测价值。结果与非危重症组比较,危重症组、极危重症组APACHEII评分及血清PBEF、IL-26水平升高(P<0.05),血清KLF2水平均低(P<0.05);与危重症组比较,极危重症组APACHEII评分及血清PBEF、IL-26水平升高,血清KLF2水平降低(P<0.05);SP患儿血清PBEF、IL-26水平与APACHEII评分呈正相关,血清KLF2水平与APACHEII评分呈负相关(P<0.05);预后不良组较预后良好组极危重症患者比例、APACHEII评分及血清PBEF、IL-26水平升高,血清KLF2水平降低(P<0.05);血清PBEF、IL-26水平升高,KLF2水平降低是SP患儿发生预后不良的危险因素(P<0.05);血清PBEF、KLF2、IL-26水平单独及联合预测患儿预后不良的AUC分别为0.769、0.820、0.814、0.933,三者联合预测价值更高(Z=4.112、3.893、4.035,P<0.001)。结论伴随SP患儿病情严重程度的增加,血清PBEF、IL-26水平升高,KLF2水平降低,三者可作为预测患儿预后转归的指标。展开更多
文摘AIM: Predictive value of serum b2-microglobulin (b2m)levels for virological breakthrough (VB) in HBeAg-negative chronic hepatitis B (CHB) patients under long-term treatment schedules including lamivudine (LAM).METHODS: Serum b2m levels were calculated during treatment in 25 CHB patients under long-term LAM monotherapy (group A) and 12 patients under initial interferon plus LAM treatment followed by LAM monotherapy (group B), using the MEIA technology. We used Cox proportional hazard models in order to investigate the association between serum b2m levels and VB.RESULTS: Seven of 25 patients (28%), 9/25 (36%) and 14/25 (56%) from group A and 0/12, 2/12 (16.6%) and 3/12 (25%) from group B exhibited VB at months 12, 24 and 36 of treatment, respectively. All patients, from both groups, who did not show VB exhibited b2m elevation in mo 3. The duration of b2m elevation was significantly longer in the virological responder's subgroup from group A than the non-responder's one (7.3±2.6 vs 3.8±3.4 mo,P = 0.02). In comparison to group A patients whose b2m levels were increased at 3 mo, patients whose b2m levels were decreased had 4.6 times higher risk of experiencing VB (RR = 4.6, P = 0.024). When baseline variables were simultaneously included in the same Cox model, decreased b2m status was still associated with increased risk of VB (RR = 12.2, P = 0.03).CONCLUSION: In HBeAg-negative CHB patients under either long-term LAM monotherapy or initial combination treatment, serum b2m levels at 3 mo of treatment,compared to baseline ones, might be a predictor of risk for VB.
文摘目的讨论血清前B细胞克隆增强因子(pre-B cell colony-enhancing factor,PBEF)、Kruppel样转录因子2(kruppel like factor 2,KLF2)、白介素-26(Interleukin-26,IL-26)与重症肺炎(severe pneumonia,SP)患儿病情严重程度及预后转归的关系。方法选择西安市儿童医院2023年3月-2025年3月收治的180例SP患儿作为研究对象,使用ELISA试剂盒分别检测血清中PBEF、KLF2、IL-26的蛋白水平;根据急性生理与慢性健康评分II(acute physiology and chronic health score,APACHEII评分)判定患儿的病情严重程度并分组为非危重症组(n=60)、危重症组(n=75)和极危重症组(n=45);根据SP患儿预后分为预后良好组(n=127)和预后不良组(n=53);血清PBEF、KLF2、IL-26水平与APACHEII评分的相关性采用Pearson法分析;多因素Logistics回归分析影响SP患儿预后转归的因素;ROC曲线分析血清PBEF、KLF2、IL-26水平对SP患儿预后转归的预测价值。结果与非危重症组比较,危重症组、极危重症组APACHEII评分及血清PBEF、IL-26水平升高(P<0.05),血清KLF2水平均低(P<0.05);与危重症组比较,极危重症组APACHEII评分及血清PBEF、IL-26水平升高,血清KLF2水平降低(P<0.05);SP患儿血清PBEF、IL-26水平与APACHEII评分呈正相关,血清KLF2水平与APACHEII评分呈负相关(P<0.05);预后不良组较预后良好组极危重症患者比例、APACHEII评分及血清PBEF、IL-26水平升高,血清KLF2水平降低(P<0.05);血清PBEF、IL-26水平升高,KLF2水平降低是SP患儿发生预后不良的危险因素(P<0.05);血清PBEF、KLF2、IL-26水平单独及联合预测患儿预后不良的AUC分别为0.769、0.820、0.814、0.933,三者联合预测价值更高(Z=4.112、3.893、4.035,P<0.001)。结论伴随SP患儿病情严重程度的增加,血清PBEF、IL-26水平升高,KLF2水平降低,三者可作为预测患儿预后转归的指标。
