CAJ | 학술논문

目的：探讨慢性乙型肝炎患者接受核苷类似物抗病毒治疗因发生耐药而停药出现肝功能异常的临床分析。方法回顾性分析7例确诊为慢性乙型肝炎接受核苷类似物治疗因发生耐药后自行停药后患者的临床表现、实验室检查及内科保守治疗情况及预后。结果耐药后停用核苷类似物治疗后会出现谷丙转氨酶(ALT)、谷草转氨酶(AST)升高，白蛋白、凝血酶原活动度(PTA)下降，病毒定量升高， e 抗原均阳性。经治疗后除1例患者死亡，其余患者肝功能恢复。结论患者在接受核苷类似物抗病毒治疗发生耐药后停药会出现肝功能损害加重，重者出现重型肝炎表现，有死亡风险，生存的病例亦有疾病进展现象。
목적：탐토만성을형간염환자접수핵감유사물항병독치료인발생내약이정약출현간공능이상적림상분석。방법회고성분석7례학진위만성을형간염접수핵감유사물치료인발생내약후자행정약후환자적림상표현、실험실검사급내과보수치료정황급예후。결과내약후정용핵감유사물치료후회출현곡병전안매(ALT)、곡초전안매(AST)승고，백단백、응혈매원활동도(PTA)하강，병독정량승고， e 항원균양성。경치료후제1례환자사망，기여환자간공능회복。결론환자재접수핵감유사물항병독치료발생내약후정약회출현간공능손해가중，중자출현중형간염표현，유사망풍험，생존적병례역유질병진전현상。
Objective To investigate clinical analysis of abnormal liver function caused by drug withdrawal after drug resistance of nucleoside analog for antiviral therapy in chronic hepatitis B patients. Methods A retrospective analysis was made on clinical manifestations, laboratory examination, conservative medical treatment status, and prognosis in 7 chronic hepatitis B patients, who suspended drug by themselves due to drug resistance in nucleoside analog for antiviral therapy. Results Withdrawal of nucleoside analog after drug resistance leaded to increased alanine aminotransferase (ALT), aspartate aminotransferase (AST) and virus quantity, decreased albumin and prothrombin time activity (PTA), and positive e antigens. After treatment, there was 1 death case, and the other patients all had recovered liver function. Conclusion Drug withdrawal after drug resistance of nucleoside analog for antiviral therapy in chronic hepatitis B patients will lead to worsen liver function damage, and severe hepatitis manifestation and risk of death will occur in critical patients. Even survival patients have progression of disease.