拉米夫定治疗CHB患者YMDD基因型耐药检测  

Detecting the YMDD Mutation During the Lamivudine Therapy in Patients with Chronic Hepatitis B

作　　者：杨柳絮[1] 赵中夫[2] 韩红莉[1] 

机构地区：[1]山西医科大学,030001 [2]长治医学院肝病研究所

出　　处：《长治医学院学报》2008年第3期180-182,共3页Journal of Changzhi Medical College

基　　金：山西省自然科学基金(2008011073-4)

摘　　要：目的:检测拉米夫定(LVD)抗HBV治疗过程中YMDD变异出现的时间和频率。方法:35例慢性乙型肝炎患者入选,接受LVD治疗,100mg/d,疗程52周。分别在治疗前及治疗后12周,20周,24周,36周和52周检测YMDD变异、HBV DNA、ALT和HBV M。结果:20周有1例出现YMDD变异,24周有2例YMDD变异,36周有4例YMDD变异,52周有5例YMDD变异;52周后,HBV DNA转阴率为74.3%(26/35),ALT复常率为71.4%(25/35),HBeAg转阴率为42.9%(15/35)。结论:LVD治疗20周前,换用或联合另一种有效的核苷(酸)类似物,可有效预防YMDD耐药的出现。Objective：To determine the time of LVD-resistance during the antiviral therapy in patients with chronic hepatitis B.Methods：Thirty-five patients with chronic hepatitis B were enrolled.They received lamivudine（LVD）100 mg/d for 52 weeks.Serum HBV DNA,alanine aminotransferase（ALT）,HBV M and YMDD were measured at 0wk,12wk,20wk,24wk,36wk and 52wk of LVD treatment.Results：One patient emerged YMDD mutation at week 20 of LVD treatment,there are 2 patients and 4 patients at week 24 and 36,respectively,at week 52,5 patients emerged YMDD mutation,the rates of undetectable HBV DNA,ALT normalization and HBeAg loss are 74.3%,71.4% and 42.9%.Conclusion：The ideal treatment is that receiving LVD for 20 weeks,then switch to another drug in order to prevent YMDD mutation during the antiviral therapy.

关 键 词：YMDD变异 拉米夫定 慢性乙型肝炎 

分 类 号：R446.6[医药卫生—诊断学]