慢性乙型肝炎患者拉米夫定耐药后的后续抗病毒治疗  

Subsequent anti-viral therapy of chronic hepatitis B patients following lamivudine resistance

作　　者：崔速南[1] 王灿[1] 汪明明[1] 

机构地区：[1]济南市传染病医院,山东济南250021

出　　处：《中国抗感染化疗杂志》2005年第5期288-290,共3页Chinese Journal of Infection and Chemotherapy

摘　　要：目的探讨慢性乙型肝炎患者拉米夫定耐药后采用α-干扰素或(和)α1胸腺肽进行后续抗病毒的治疗效果。方法66例拉米夫定耐药患者,分治疗组和对照组。治疗组36例,用α-干扰素或(和)α1胸腺肽治疗1个月后停用拉米夫定,然后继续用α-干扰素或(和)α1胸腺肽治疗,共6个月。对照组30例,直接停用拉米夫定,不用其他抗病毒药。定期进行血清肝功能和病毒学指标检测。结果治疗组肝功能复常率、HBV DNA阴转率和HBeAg/抗-HBe转换率均明显高于对照组,治疗组HBV DNA阴转率最高为27.8%,HBeAg/抗-HBe转换率最高为25.0%。结论慢性乙型肝炎患者拉米夫定耐药后采用α-干扰素或(和)α1胸腺肽进行后续抗病毒治疗是有益的。Objective To evaluate the efficacy of α1-interferon alone or combined with α1- thymosin in the treatmeat of chronic hepatitis B patients following lamivudine resistance. Methods Sixty-six patients with lamivudine resistance were enrolled and randomized into two groups： treatment group and control group. In the treatment group, patients （n=36） received α1-interferon or/and α1- thymosin for 1 month. Then lamivudine was discontinued. Patients continued treatment with α1-interferon or/and α1- thymosin for 5 months. Full course of treatment was 6 months. In control group （n=30）, lamivudine was directly discontinued. No antiviral agent was given. Liver function tests and serum virologic responses were evaluated at regular interval in all patients. Results Normalization rate of liver function, HBV DNA seroconversion rate and HBeAg/anti-HBe seroconversion rate in the treatment group were significantly higher than those in control group. HBV DNA seroconversion rate was up to 27.80%. HBeAg/anti-HBe seroconversion rate was up to 25.0%. Conclusions The study suggests that α1-interferon alone or combined with α1- thymosin as subsequent antiviral therapy following lamivudine resistance is beneficial for the treatment of chronic hepatitis B.

关 键 词：乙型肝炎 慢性 拉米夫定耐药 Α-干扰素 Α1胸腺肽 抗病毒治疗 

分 类 号：R512.62[医药卫生—内科学] R978.7[医药卫生—临床医学]