替比夫定初治慢性乙型肝炎患者早期病毒学应答的影响因素  

The influencing factors for early virological response of telbivudine treated patients with chronic hepatitis B

作　　者：林春[1,2] 周锐[1,2] 黄祖雄[1,2] 郑彩霞[1,2] 张冬青[1,2] 孙芳[1,2] 黄水文[1,2] 林勇[1,2] 潘晨[1,2] 

机构地区：[1]福州市传染病医院 [2]福建医科大学附属传染病医院,福州市350025

出　　处：《中华实验和临床感染病杂志（电子版）》2012年第6期36-38,共3页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：福州市科技计划项目(No.2009-G-102);福建省卫生厅青年科研课题(No.2011-2-43)

摘　　要：目的探讨替比夫定初治慢性乙型肝炎患者早期病毒学应答的影响因素。方法选择2007年1月～2012年4月本院门诊收治的慢性乙型肝炎患者共108例,接受替比夫定治疗至少12周。入组患者每2周随访1次直至12周,记录患者的一般临床资料、治疗基线时肝功能指标、HBVDNA定量、HBV表面标志物水平以及每2周随访时的HBVDNA定量情况。采用Cox回归模型分析替比夫定初治慢性乙型肝炎患者早期病毒学应答的影响因素。结果本研究中达到早期病毒学应答患者共76例,占70.4%,未达到早期病毒学应答患者32例,占29.6%,Cox回归模型分析结果显示,患者家族史、TBil值、AST水平、基线HBVDNA定量是替比夫定初治慢性乙型肝炎患者早期病毒学应答的有效预测因素。结论影响替比夫定初治慢性乙型肝炎患者早期病毒学应答的主要因素有家族史、TBil、AST和基线HBVDNA载量。Objective To analyze the influent factors for early virological response of telbivudine treated patients with chronic hepatitis B. Methods Total of 108 patients with chronic hepatitis B in our hospital from January 2007 to April 2012 were enrolled in the study, reprospectively. All patients who had not been treated with oral nucleoside analogue were assigned to receive telbivudine 600 mg/d and followed up every 2 weeks until 12 weeks. The clinical features, liver function, HBV DNA, positive or negative of HBeAg and HBeAb at baseline were recorded. And HBV DNA quantitation at all following-up time were recorded. Analysis on the ilffluencing factors for early virological response of telbivudine treatment for patients with chronic hepatitis B were carried out by the Cox proportional hazard model. Results Early virological response occured on 76 patients （70.4%）. The result of Cox proportional hazard model indicated that family medical history, TBil, AST and HBV DNA quarttitation were the predictors for early virological response of telbivudine treated patients with chronic hepatitis B. Conclusions Patients with chronic hepatitis B with no family medical history, high TBil, high AST and low HBV DNA quantitation may response well to telbivudine treatment.

关 键 词：肝炎 乙型 慢性 早期病毒学应答 影响因素 替比夫定 

分 类 号：R512.62[医药卫生—内科学]