替比夫定治疗HBeAg阳性慢性乙型肝炎早期病毒学应答对疗效的预测价值  

Early prediction of efficacy of telbivudine in the treatment of patients with HBeAg-positive chronic hepatitis B

作　　者：徐静[1] 李宜[1] 

机构地区：[1]安徽医科大学附属省立医院感染病科,合肥市230001

出　　处：《实用肝脏病杂志》2013年第2期131-133,共3页Journal of Practical Hepatology

摘　　要：目的评价替比夫定治疗HBeAg阳性慢性乙型肝炎患者早期病毒学应答对疗效的影响。方法 82例HBeAg阳性慢性乙型肝炎患者接受替比夫定治疗52周,观察4周、12周和24周病毒学应答与不应答患者52周的疗效。结果在治疗52周时,82例患者ALT复常率、HBV DNA转阴率、HBeAg阴转率和HBeAg血清转换率分别为95.1%、95.1%、56.1%和32.9%;在治疗4周时HBV DNA转阴45例,未转阴37例。两组52周HBV DNA转阴率、ALT复常率、HBeAg阴转率和HBeAg血清转换率分别为100.0%对89.2%(P<0.05)、100.0%对89.2%(P<0.05)、64.4%对45.9%和37.8%对27.0%;在治疗12周时HBV DNA转阴67例,未转阴15例。两组52周HBV DNA转阴率、ALT复常率、HBeAg阴转率和HBeAg血清转换率分别为100.0%对73.3%(P<0.05)、100.0%对73.3%(P<0.05)、67.2%对6.7%(P<0.05)和40.3%对0.0%(P<0.05);在治疗24周时HBV DNA转阴78例,未转阴4例。两组52周HBV DNA转阴率、ALT复常率、HBeAg阴转率和HBeAg血清转换率分别为98.7%对25.0%(P<0.05)、98.7%对25.0%(P<0.05)、59.0%对0.0%(P<0.05)和34.6%对0.0%。结论替比夫定治疗HBeAg阳性慢性乙型肝炎患者早期病毒学应答对疗效有预测作用,早期对治疗应答的患者可以继续接受该治疗方案。Objective To predict the efficacy of telbivudine in the treatment of patients with HBeAg-positive chronic hepatitis B by early virological response. Methods Eighty-two patients with HBeAg-positive CHB were en- rolled in this study,and the virological response at week 4,12 and 24 were recorded. Results At the end of week 52,the rates of serum ALT normalization, HBV DNA loss, HBeAg negativity and HBeAg/HBeAb seroconversion were 95.1%,95.1%,56.1% and 32.9%,respectively;at week 4,we found serum HBV DNA loss in 45,while still pos- itive in 37. The rates of serum ALT normalization, HBV DNA loss, HBeAg negativity and HBeAg/HBeAb sero- conversion in the two groups were 100.0% vs.89.2%（P〈O.05）,100.0% vs.89.2%（P〈0.05）,64.4% vs.45.9% and 37.8% vs. 27.0%,respectively;at week 12,67 patients with hepatitis B had,and 15 had not serum HBV DNA loss. The rates of serum ALT normalization,HBV DNA loss,HBeAg negativity and HBeAg/HBeAb seroconversion in the two groups were 100.0% vs. 73.3%（P〈0.05）,100.0% vs. 73.3%（P〈0.05）,67.2% vs. 6.7%（P〈0.05） and 40.3% vs. 0.0%（P〈0.05）,respectively;at week 24,78 patients had,and 4 had not serum HBV DNA loss. The rates of serum ALT normalization, HBV DNA loss, HBeAg negativity and HBeAg/HBeAb seroconversion in the two groups were 98.7% vs. 25.0%（P〈0.05）,98.7% vs. 25.0%（P〈0.05）,59.0% vs. 0.0%（P〈0.05）and 34.6% vs. 0.0% ,respectively. Conclusion In HBeAg-positive chronic hepatitis B patients treated with telbivudine,serum virological response at early stage can be used to predict the efficacy in the future.

关 键 词：慢性乙型肝炎 替比夫定 治疗 应答 

分 类 号：R512.62[医药卫生—内科学]