拉米夫定治疗慢性乙型肝炎的疗效及其预测因素分析  

The efficacy of lamivudine treatment in patients with chronic hepatitis B and the analysis of predicting factors

作　　者：吴娜[1] 苏菲[1] 张振华[1] 夏国美[1] 张婷婷[1] 张玲[1] 郜玉峰[1] 李旭[1] 

机构地区：[1]安徽医科大学第一附属医院感染病科,合肥市230022

出　　处：《实用肝脏病杂志》2010年第1期29-30,47,共3页Journal of Practical Hepatology

基　　金：973计划前期研究专项课题基金(2009CB526411);国家自然科学基金(30771907;30700698);安徽省高校省级自然科学研究项目(KJ2008B300)

摘　　要：目的评价拉米夫定治疗慢性乙型肝炎的疗效及影响疗效的预测因素。方法应用拉米夫定治疗90例慢性乙型肝炎患者,观察48周的疗效。结果在90例患者中,完全应答21例(21.3%)、部分应答64例(71.1%)、无应答5例(5.6%);在基线ALT≥2×ULN和HBeAg阴性患者,完全应答率及病毒学应答率较高(P<0.05);治疗4周时HBVDNA下降≥2lg copies/ml者,完全应答率为25.5%,病毒学应答率为91.5%;在71例HBeAg阳性患者中,HBeAg转阴21例(29.6%),出现HbeAg/抗HBe血清学转换7例(9.9%);年龄、性别和乙型肝炎家族史对疗效无预测价值。结论拉米夫定治疗慢性乙型肝炎患者疗效显著,基线ALT水平高、HBVDNA水平低、HBeAg阴性和治疗4周HBVDNA下降超过2lg copies/ml者,疗效较好。Objective To evaluate the efficacy of lamivudine treatment in patients with chronic hepatits B and analysis of predicting factor. Methods Ninety patients with chronic hepatitis B were treated with lamivudine for 48 weeks. Results 21 patients （21.3%） had complete response （CR）,64 patients （71.1%） had partial response （PR） and 5 patients （5.6%） were non- response （NR） in the 90 patients at the end of the regimen;In patients with baseline serum ALT≥2xupper limit of normal （ULN） and with HBeAg-negative,the rates of CR and virological response were higher,while the serum HBV DNA load had no predicting value;In 79 patients with baseline HBeAg-positive,HBeAg negativity rate was 29.6% and HBeAg/anti-HBe seroconversion rate was 9.9%; Gender and hepatitis B infection of family members were not related to the efficacy. Conclusion Lamivudine is effective in treatment of patients with chronic hepatitis B and the baseline serum ALT, HBeAg status and early response at 4 weeks have a predicting value for 48 week efficacy.

关 键 词：慢性乙型肝炎 拉米夫定 疗效 

分 类 号：R512.62[医药卫生—内科学] R512.63[医药卫生—临床医学]