CAJ | 학술논문

目的：了解预存耐药检测对慢性乙型肝炎患者核苷（酸）类药物抗病毒治疗效果的影响。方法选择绵阳地区600例慢性乙型肝炎患者，随机分为治疗组和对照组，治疗组患者在核苷（酸）类药物抗病毒治疗前进行预存耐药检测，对照组不检测，观察两组患者48周的耐药率、血清学应答情况。结果预存耐药检出率为14．57％，抗病毒治疗后，治疗组24、48周耐药率及48周总耐药发生率均显著低于对照组（P ＜0．01）。治疗组患者48周 HBV DNA 转阴率、HBeAg 血清学转换率均优于对照组（P ＜0．01）。结论慢性乙型肝炎患者预存耐药与核苷（酸）类药物耐药、及血清学应答密切相关，慢性乙型肝炎患者在核苷（酸）类药物抗病毒治疗前进行预存耐药，有助于临床选择治疗药物，实现抗病毒治疗个体化，经治疗后跟踪患者的耐药情况，为临床合理用药提供指导，具有重要的临床实用价值。
목적：료해예존내약검측대만성을형간염환자핵감（산）류약물항병독치료효과적영향。방법선택면양지구600례만성을형간염환자，수궤분위치료조화대조조，치료조환자재핵감（산）류약물항병독치료전진행예존내약검측，대조조불검측，관찰량조환자48주적내약솔、혈청학응답정황。결과예존내약검출솔위14．57％，항병독치료후，치료조24、48주내약솔급48주총내약발생솔균현저저우대조조（P ＜0．01）。치료조환자48주 HBV DNA 전음솔、HBeAg 혈청학전환솔균우우대조조（P ＜0．01）。결론만성을형간염환자예존내약여핵감（산）류약물내약、급혈청학응답밀절상관，만성을형간염환자재핵감（산）류약물항병독치료전진행예존내약，유조우림상선택치료약물，실현항병독치료개체화，경치료후근종환자적내약정황，위림상합리용약제공지도，구유중요적림상실용개치。
Objective To study the effect of pre-existing-resistance virus detection on antiviral treatment efficacy of nucleoside and nucleotide analogs (NAs)in chronic hepatitis B patients.Methods Six hundred chronic hepatitis B patients in Mianyang districtwere divided into treatment group and control group at random.Patients in treatment group received pre-existing-resistance virus detection before antiviral therapy,while control group underwent no detection.The drug resistance rate and serological response of two groups were observed in 48 weeks.Results Pre-existing drug resistance rate was 14.57%.Drug resistance rates in treatment group at week 24,week 48 and total drug resistance rate in 48 weeks were significantly lower than that in the control group (P <0.01 ).HBV DNA negative rate and HBeAg seroconversion rate in treatment group were higher than those in control group at week 48 (P <0.01 ).Conclusions Pre-existing resistance is closely related with NAs resistance and serological response.Pre-existing resistance detection before antiviral therapy in chronic hepatitis B patients contributes to the clinical choice of targeted therapy drugs,helps to realize the individual therapy and provides important clinical application values.