中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2009年
9期
28-29
,共2页
拉米夫定%慢性乙型肝炎%HBVDNA%HBeAg
拉米伕定%慢性乙型肝炎%HBVDNA%HBeAg
랍미부정%만성을형간염%HBVDNA%HBeAg
Lamivudine%HepatitisB%chronic%HBVDNA%HBeAg
目的 分析拉米夫定治疗HBeAg阳性慢性乙型肝炎52周疗效与24周抑制HBVDNA程度的相关性,探讨临床疗效预测指标.方法 回顾性分析拉米夫定治疗HBeAg阳性慢性乙型肝炎患者96例,根据治疗24周时HBVDNA是否阴转(HBVDNA＜103拷贝/ml)分为病毒学转阴组和未转阴组,比较两组治疗52周时HBVDNA、HBeAg、ALT和YMDD病毒变异.结果 治疗52周时,转阴组和未转阴组HBVDNA、HBeAg转阴率、ALT复常率和YMDD变异率分别为87.7%、59.6%、93.0%、3.5%和48.7%、30.8%、2.6%、74.4%、28.2%,有统计学意义(P＜0.01).结论 拉米夫定治疗24周时,若HBVDNA＜10 3拷贝/ml,52周可获得较好疗效;若HBVDNA＞10 3拷贝/ml,则52周时疗效不佳且发生耐药的可能性增加.24周拉米夫定对HBVDNA的抑制程度可作为1年疗效的预测指标.
目的 分析拉米伕定治療HBeAg暘性慢性乙型肝炎52週療效與24週抑製HBVDNA程度的相關性,探討臨床療效預測指標.方法 迴顧性分析拉米伕定治療HBeAg暘性慢性乙型肝炎患者96例,根據治療24週時HBVDNA是否陰轉(HBVDNA＜103拷貝/ml)分為病毒學轉陰組和未轉陰組,比較兩組治療52週時HBVDNA、HBeAg、ALT和YMDD病毒變異.結果 治療52週時,轉陰組和未轉陰組HBVDNA、HBeAg轉陰率、ALT複常率和YMDD變異率分彆為87.7%、59.6%、93.0%、3.5%和48.7%、30.8%、2.6%、74.4%、28.2%,有統計學意義(P＜0.01).結論 拉米伕定治療24週時,若HBVDNA＜10 3拷貝/ml,52週可穫得較好療效;若HBVDNA＞10 3拷貝/ml,則52週時療效不佳且髮生耐藥的可能性增加.24週拉米伕定對HBVDNA的抑製程度可作為1年療效的預測指標.
목적 분석랍미부정치료HBeAg양성만성을형간염52주료효여24주억제HBVDNA정도적상관성,탐토림상료효예측지표.방법 회고성분석랍미부정치료HBeAg양성만성을형간염환자96례,근거치료24주시HBVDNA시부음전(HBVDNA＜103고패/ml)분위병독학전음조화미전음조,비교량조치료52주시HBVDNA、HBeAg、ALT화YMDD병독변이.결과 치료52주시,전음조화미전음조HBVDNA、HBeAg전음솔、ALT복상솔화YMDD변이솔분별위87.7%、59.6%、93.0%、3.5%화48.7%、30.8%、2.6%、74.4%、28.2%,유통계학의의(P＜0.01).결론 랍미부정치료24주시,약HBVDNA＜10 3고패/ml,52주가획득교호료효;약HBVDNA＞10 3고패/ml,칙52주시료효불가차발생내약적가능성증가.24주랍미부정대HBVDNA적억제정도가작위1년료효적예측지표.
Objective To investigate the possibilities of an association between the degrees of HBV suppression with lamivudine-treatment at week 24 and week 52 in HBeAg-pesitive chronic hepatitis B patients and to find a useful predictor for treatment efficacy.Methods 96 patients with HBeAg-positive chronic hepatitis B were treated with lamivudine 100 mg per day for 52 week.They were categoized into2 groups according to their serum HBVDNA levels(copies/ml) at week 24:HBVDNA seroconversion group(＜103 copiea/ml)and HBVDNA non-sercoversion group (＞10 3 copies/ml).We retrospectively analyed the treatment efficacy of two groups.Results At week 52,the rate of HBVDNA undetectable and HBeAg seroconversion and ALT normalization in HBVDNA seroconversion group were higher than that in HBVDNA non-seroconversion group,but the rate of YMDD mutation was lower.The difference was significant in two groups.Conclusion HBVDNA PCR-undetectable at week 24 in lamivudine-treated HBeAg-positive hepatitis B patients suggests a better efficacy and lower viral resistance at week52.The dgree of supression of HBV at 24 weeks may be used as a predictor of one year outcome.
