拉米夫定治疗干扰素无应答的儿童慢性乙型肝炎疗效分析  

The efficacy of lamivudine treatment for chronic hepatitis B in children unresponsive to interferon-alpha

作　　者：俞海英[1] 杨永峰[1] 丁巧云[1] 潘剑[1] 王雷[1] 曹兴国[1] 杨觉民[1] 

机构地区：[1]东南大学附属南京市第二医院十五病区,210003

出　　处：《肝脏》2011年第6期446-448,共3页Chinese Hepatology

基　　金：南京市科技项目(YKK1005)

摘　　要：目的对于扰素治疗无应答的儿童慢性乙型肝炎使用拉米夫定序贯治疗,探讨拉米夫定对儿童慢性乙型肝炎的疗效和安全性。方法 40例干扰素治疗无应答的慢性乙型肝炎患儿,口服拉米夫定每日3 mg/kg体质量,最大量100mg/d,观察3年;定期检查血清生化学指标、HBV血清标志物、HBV DNA定量变化;并测身高、体质量,记录不良反应。结果 3年中HBV DNA阴转16例,阴转率40%;HBeAg效价下降14例,下降率35%,HBeAg/抗-HBe血清转换10例,转换率25%;血清ALT、AST逐渐下降并接近正常;身高、体质量、智力均与同龄健康儿童一致。结论拉米夫定对干扰素治疗无应答的患儿HBV DNA有明显抑制作用,在儿童慢性乙型肝炎治疗中安全有效,未发现其对儿童的生长发育有影响。Objective To investigate the efficacy and the safty of lamivudine treatment in children with chronic hepatitis B who did not respond to previous interferon-alpha treatment.Methods Lamivudine,3 mg/（kg ？ day）（maximum,100 mg/ day）.was given for 3 years to 40 children,aged 7 to 16 years,with chronic HBV infection who did not respond to previous interferon treatment.Data gathered from medical record review included weight,height,signs and symptoms of hepatitis,alanine aminotransferase（ALT） levels,serologic markers,hepatitis B virus（HBV） DNA levels and serious adverse events（SAEs）.Results At the end of 3 year,16 of 20（40%） patient had sustained undetectable HBV DNA and HBV DNA declined by 35%.HBeAg/anti-HBe seroconversion was achieved in 25%and ALT normalization has also been observed at the end of therapy.Evaluation of safety data revealed no SAEs related to lamivudine.Conclusion The treatment of lamivudine for children with chronic hepatitis B after failure of interferon therapy was efficacy and lamivudine could inhibit the HBV replication.Up to 3 years of lamivudine treatment was safe in children.

关 键 词：拉米夫定 儿童 慢性乙型肝炎 干扰素 

分 类 号：R725.1[医药卫生—儿科]