血清CYP2R1对核苷类似物/IFN-α治疗CHB疗效的预测价值

Serum CYP2R1 pair nucleoside analogues/IFN-α predictive value of efficacy in the treatment of CHB

摘要:

目的探讨血清细胞色素P450家族2亚家族R成员1(CYP2R1)水平对核苷类似物(NAs)/干扰素-α(IFN-α)治疗慢性乙型肝炎(CHB)疗效的预测价值。方法选取78例既往接受NAs治疗的CHB患者为CHB组,均给予聚乙二醇干扰素(Peg-IFN-α-2a)治疗48周(前8周联用恩替卡韦),根据抗病毒疗效分为应答组和非应答组；另选取40例健康志愿者为对照组。比较CHB组与对照组、应答组与非应答组CYP2R1水平,ROC评估CYP2R1预测抗病毒疗效的价值。结果CHB组治疗前血清CYP2R1低于对照组,治疗12、24周应答组CYP2R1高于非应答组(P＜0.05)。Logistic回归分析显示治疗前HBV DNA载量、25(OH)D3及治疗12、24周CYP2R1水平是影响抗病毒疗效的独立危险因素(P＜0.05)。治疗12周CYP2R1预测抗病毒疗效的ROC曲线下面积(AUC)为0.673,灵敏度为60.42%,特异度为70.00%,治疗24周分别为0.774、72.92%、83.33%,治疗24周较12周血清CYP2R1预测抗病毒疗效效能高(P＜0.05)。结论NAs/IFN-α治疗过程中CHB患者CYP2R1水平变化与IFN-α抗病毒疗效有关,治疗24周的CYP2R1水平可作为预测IFN-α抗病毒疗效敏感指标。

Abstract:

To investigate the relationship between serum cytochrome P450 family 2 subfamily R member 1 (CYP2R1) level and the clinical efficacy of nucleoside analogs (NAs)/interferon-α (IFN-α) in the treatment of chronic hepatitis B (CHB). Methods78 patients with CHB who had previously received NAs therapy were selected as the research group, and they were all given pegylated interferon (Peg-IFN-α-2a) for 48 weeks (the first 8 weeks combined with entecavir), divided into response group and non-response group according to antiviral efficacy. Another 40 healthy volunteers were selected as the control group. The CYP2R1 levels of the study group and the control group, the response group and the non-responder group were compared. The predictive value of CYP2R1 on IFN-α antiviral efficacy was evaluated by receiver operating characteristic (ROC) curve. ResultsThe serum CYP2R1 in the study group before IFN-α treatment was lower than that in the control group, and the CYP2R1 in the response group was higher than that in the non-response group, after 12 and 24 weeks of treatment (P＜0.05). Logistic regression analysis showed that HBV DNA load before treatment, 25(OH)D3 and CYP2R1 levels at 12 and 24 weeks after treatment were independent risk factors for antiviral efficacy (P＜0.05). The area under the ROC curve (AUC) of CYP2R1 predicting antiviral efficacy at 12 weeks of treatment was 0.673, the sensitivity was 60.42%, and the specificity was 70.00%, and 24-weektreatment were 0.774,72.92%, 83.33%. The efficacy of serum CYP2R1 in predicting antiviral efficacy was higher at 24 weeks of treatment than at 12 weeks (P＜0.05). ConclusionThe change of CYP2R1 level in CHB patients during NAs/IFN-α treatment is related to the antiviral efficacy of IFN-α, and the CYP2R1 level at 24 weeks of treatment can be used as a sensitive indicator to predict the antiviral efficacy of IFN-α.