替比夫定对慢性乙型肝炎患者HBV DNA含量和肝功能的影响  

Therapeutic effects of telbivudine(LdT) on HBV DNA and liver function in patients with chronic hepatitis B

作　　者：张雪华[1] 朱传武[1] 罗湘蓉[1] 柴晓哲[1] 

机构地区：[1]苏州市第五人民医院传染科,江苏苏州215007

出　　处：《中国病毒病杂志》2012年第4期301-304,共4页Chinese Journal of Viral Diseases

摘　　要：目的观察替比夫定(LdT)治疗前、治疗后第12、24和48周时对慢性乙型肝炎(CHB)患者HBV DNA含量、e抗原血清转换和肝功能的影响。方法 107例CHB患者给予口服LdT 600mg/d治疗48周,观察在治疗前、治疗后第12、24和48周时患者的临床表现以及血清中HBV DNA含量、e抗原滴度(HBeAg)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素、白蛋白、直接胆红素、谷氨酰转移酶、胆碱酯酶、白细胞、中性粒细胞、红细胞和血小板计数的变化。结果与治疗前相比,107例患者经LdT治疗后血清中HBV DNA含量、HBeAg、ALT、AST、直接胆红素、谷氨酰转移酶、胆碱酯酶水平均明显降低(P<0.05,P<0.01),白蛋白、白细胞水平明显升高(P<0.05,P<0.01)。同时,LdT治疗前后血清总胆红素、中性粒细胞、红细胞和血小板计数水平差异无统计学意义。相关性分析表明,HBV DNA含量的变化与患者血清中ALT、AST、谷氨酰转移酶、HBeAg呈正相关(P<0.01),与白蛋白、白细胞水平呈负相关(P<0.05,P<0.01)。结论 LdT治疗CHB患者近期疗效显著,主要作用机制为抑制HBV复制和改善肝功能。Objective To study the effects of telbivudine（LdT） on HBV DNA and liver function in patients with chronic hepatitis B.Methods The HBeAg,HBV DNA,ALT,AST,total bilirubin,albumin,direct bilirubin,aminoacyltransferase,cholinesterase,leucocyte,neutrophil,red cells and blood platelet count were measured at weeks 0,12,24 and 48 following LdT treatment in a total of 107 patients with chronic hepatitis B.Results HBeAg,HBV DNA,ALT,AST,direct bilirubin,aminoacyltransferase and cholinesterase levels were obviously decreased after treated by LdT（P0.05 or P0.01）;on the other hand,the albumin level and leucocyte counts were significantly increased（P0.05 and P0.01,respectively）.Total bilirubin,neutrophil and red blood cells and blood platelet counts did not show marked changes before and after LdT treatment（P0.05）.Changes in HBV DNA amount and in levels of ALT,AST,aminoacyltransferase and HBeAg were positively correlated（P0.01）;whereas changes in HBV DNA were negatively correlated with that in albumn levels and leucocyte counts（P0.05 and P0.01,respectively）.Conclusions LdT is clinically effective to treat chronic hepatitis B by decreasing the HBV replication and improving the liver function.

关 键 词：替比夫定 慢性乙型肝炎 肝功能 HBV DNA 

分 类 号：R512.62[医药卫生—内科学]