CAJ | 학술논문

目的探讨单独使用拉米夫定后引起应答不佳的原因,特别是酪氨酸-蛋氨酸-天门冬氨酸-天门冬氨酸(YMDD)变异的发生相关因素.方法回顾性分析160例单独使用拉米夫定后出现应答不佳的病例,进行基线参数值、出现应答不佳时间、治疗中HBVDNA载量分析,分别研究它们与出现应答不佳的关系.结果随着拉米夫定使用时间延长应答不佳的出现概率逐渐增加:12个月时变异率19.67％,36个月时达到49.18％ (P ＜0.05).应答不佳的原因很多,YMDD变异只是较常见的一个.基线HBVDNA载量、ALT值与应答不佳出现率、YMDD变异率均有明确关系,分组比较,差异有统计学意义(P＜0.05).结论基线ALT水平越低、HBVDNA滴度越高,出现应答不佳和YMDD变异概率越大.
목적 탐토단독사용랍미부정후인기응답불가적원인,특별시락안산-단안산-천문동안산-천문동안산(YMDD)변이적발생상관인소.방법 회고성분석160례단독사용랍미부정후출현응답불가적병례,진행기선삼수치、출현응답불가시간、치료중HBVDNA재량분석,분별연구타문여출현응답불가적관계.결과 수착랍미부정사용시간연장응답불가적출현개솔축점증가:12개월시변이솔19.67％,36개월시체도49.18％ (P ＜0.05).응답불가적원인흔다,YMDD변이지시교상견적일개.기선HBVDNA재량、ALT치여응답불가출현솔、YMDD변이솔균유명학관계,분조비교,차이유통계학의의(P＜0.05).결론 기선ALT수평월저、HBVDNA적도월고,출현응답불가화YMDD변이개솔월대.
Objective To explore the use of lamivudine alone induced the poor response,especially the related factors of the occurrence of YMDD.Methods Retrospective analysis of 160 cases of the poor answering cases after lamivudine treatment,the baseline parameter values,the time appearing to the poor answering and the HBVDNA load in treatment were analyzed,to study their relationship with poor response.Results The lamivudine prolonged,the poor response to the probability gradually increase.The mutation rate in the 12nd month was 19.67％ and in the 36th month was 49.18％ ( P ＜ 0.05 ).Response to the many reasons,the YMDD mutation is the more common one.The relationship among HBVDNA load,ALT level on baseline and the rate of poor response emergence,the YMDD mutation rate was clear.By comparison in groups,the difference was significant (P＜0.05).Conclusion The lower baselins of ALT level,the higher of HBVDNA load,the greater probability of the poor response and the YMDD mutation.