阿德福韦酯对慢性乙型肝炎患者血清ccc DNA的影响  

Effect of adefovir dipivoxil on serum covalently closed-circular DNA of patients with chronic hepatitis B

作　　者：王岐洁[1] 陈青锋[1] 肖萍[1] 杨彦麟[1] 魏喜生[1] 何强[1] 周萍[1] 

机构地区：[1]兰州大学第一医院传染病研究室,兰州市730000

出　　处：《中华实验和临床感染病杂志（电子版）》2009年第3期41-44,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：兰州大学医学科研基金(LZUYX200723)

摘　　要：目的探讨阿德福韦酯对慢性乙型肝炎患者血清HBV ccc DNA的影响。方法40例慢性乙型肝炎患者,按1:1随机分配接受阿德福韦酯或安慰剂治疗,所有患者均治疗52周并在停药后随访52周;应用实时荧光定量聚合酶链反应技术检测慢性乙型肝炎患者0周、26周、52周、78周、104周血清HBV ccc DNA及HBV DNA含量。结果治疗组20例患者治疗前(0周)血清HBV ccc DNA中位数水平为8.29×106拷贝/ml(与对照组相比P>0.05);接受阿德福韦酯治疗半年(26周)及1年(52周)血清HBV ccc DNA中位数水平分别为2.61×104拷贝/ml、7.78×103拷贝/ml(与治疗前相比两者P<0.05),停药半年(78周)及1年(104周)血清HBV ccc DNA中位数水平分别为3.38×104拷贝/ml、3.60×104拷贝/ml(与治疗前相比两者P<0.05);接受阿德福韦酯治疗半年及1年血清HBV ccc DNA分别下降2.502log10、3.028log10(与对照组相比两者P<0.05),停药半年及1年血清HBV ccc DNA较停药时上升0.638log10、0.665log10(与对照组相比两者P<0.05)。结论阿德福韦酯对血清HBV ccc DNA有明显抑制作用;血清HBV ccc DNA可作为阿德福韦酯抗病毒治疗的重要监测指标。Objective To investigate the impact of adefovir dipivoxil on serum covalently closedcircular DNA （ ccc DNA） of patients with chronic hepatitis B. Methods Fourty patients were randomly assigned to receive adefovir dipivoxil or placebo in a ratio of 1： 1. All patients were treated for 52 weeks and followed up by another 52 weeks. Serum HBV ccc DNA and HBV DNA levels were detected with real-time polymerase chain reaction （PCR） at the time of 0, 26, 52, 78 and 104 weeks. Results Before the treatment （0 week）, the median level of serum HBV ccc DNA of 20 patients in the observing group was 8.29 ×10^6 copies/ml, which was insignificant compared with the control group （ P 〉 0.05 ） ; median serum HBV ccc DNA dropped to 2.61 ×10^4 copies/ml and 7.78 ×10^3 copies/ml after adefovir dipivoxil treatment for half a year （26 weeeks） and one year （ 52 weeeks ）, respectively, which were significant （ P 〈 0.05 for both） compared with the starting point. Half a year （78 weeks） and one year （104 weeks） after stoping receiving adefovir dipivoxil, patients＇ serum HBV ccc DNA showed an average of 3.38 ×10^4 copies/ml and 3.60 ×10^4 copies/ml, which were both significant compared with 0 weeek treatment （ P 〈 0.05 for both）. After received adefovir dipivoxil for half a year and one year, patients＇ serum HBV ccc DNA averagely decreased 2.502 log10 and 3. 028 log10, which were both significant compared with the control group （ P 〈 0.05）. After stopping receiving adefovir dipivoxil for half a year and one year, patients＇ serum HBV ccc DNA had an increase which showd 0.638 log10 and 0.665 log10, which were both significant compared with the control group （P〈0.05）. Conclusions Adefovir dipivoxil has a significant effect on serum HBV ccc DNA which can be used as important monitoring indicators of virus resistance.

关 键 词：慢性乙型肝炎 实时荧光定量聚合酶链反应 共价闭合环状DNA 

分 类 号：R512.6[医药卫生—内科学]