阿德福韦酯治疗HBeAg阳性失代偿期乙肝肝硬化的影响因素  

Efficacy of adefovir dipivoxil on the patients with HBV cirrhosis at HBeAg positive decompensated period

作　　者：符娟[1] 吴彪[1] 蔡笃运[1] 陈所贤[1] 林锋[1] 

机构地区：[1]海南省人民医院感染科,海南海口570311

出　　处：《中国热带医学》2013年第2期204-207,共4页China Tropical Medicine

摘　　要：目的探讨阿德福韦酯治疗HBeAg阳性失代偿期乙肝肝硬化患者的疗效影响因素。方法对接受阿德福韦酯治疗的123例患者中的75例HBeAg阳性失代偿期乙肝肝硬化患者的病历资料进行回顾性分析。结果HBeAg阳性失代偿期乙肝肝硬化患者HBV DNA阴转率分别为48%,ALT复常率为84%,VB发生率为6.7%;24%的患者出现HBeAg阴转,14.7%出现HBeAg血清学转换。疗效比较:不同基线ALT水平比较,Child-Pugh评分下降2分比率差异有统计学意义(P<0.05),不同基线HBV DNA,Child-Pugh评分下降2分比率差异均有统计学意义(P<0.05),有30周病毒学应答与无30周病毒学应答患者的HBV DNA阴转率,Child-Pugh评分下降2分比率差异有统计学医学(P<0.05)。结论阿德福韦酯基线HBV DNA<1×107拷贝/ml、HBeAg阳性的失代偿期乙肝肝硬化患者中,疗效相对较好。30周有病毒学应答对阿德福韦酯疗效有预测价值。Objective To explore the efficacy of adefovir dipivoxil （ADV）in treatment of the patients with HBV cirrhosis at HBeAg positive and decompensated period. Methods The 75 patients with HBV cirrhosis at HBeAg positive and deeompensated period from March 2007 to August 2011 treated with lOmg of ADV a day for the duration of above 48 weeks in Hainan People＇s Hospital were retrospectively analyzed. Results HBV DNA negative rate of 75 patients were 48%, ALT recovery rate were 84%, the normal rate of virus breakthrough （VB）were 6.7%, HBeAg negative conversion rate were 24% and HBeAg seroconversion rate were14.7%. There was statistically significant difference of Child-Pugh score reduced by 2 point （P〈0.O5）among different groups with different levels of ALT and groups with different HBV DNA. Statistical difference of HBeAg seroconversion rate and Child-Pugh score reduced by 2 point were found among the patients withVR and a response at 30th weeks and those without a response at 30th weeks （P〈0.05）. Conclusions ADV is effective on the patients with HBV cirrhosis in HBeAg positive decompensated period with their level of HBV DNA 〈1 × 107copies/ml. Viroglogical response rate of 30th weeks possesses an important predictive value.

关 键 词：肝硬化 失代偿 阿德福韦酯 影响因素 

分 类 号：R575.2[医药卫生—消化系统]