慢性乙型肝炎治疗达标停药后复发与HBV-DNA载量关系  

Relationship between HBV-DNA load and withdrawal relapse after achieving the therapeutic end-point criteria in chronic hepatitis B patients

作　　者：刘树人[1] 欧阳石[1] 陈汉先[1] 张雁[1] 陈阳述[1] 孔祥平[1] 

机构地区：[1]解放军第458医院全军肝脏病防治中心,广州510600

出　　处：《中华实用诊断与治疗杂志》2013年第7期663-664,667,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：中国人民解放军总后勤部卫生部全军医学科学技术研究课题资助项目(08BJZ07)

摘　　要：目的探讨核苷(酸)类似物(nucleos(t)ide analogues,NA)治疗慢性乙型肝炎达标停药后复发率、复发时HBV-DNA水平与治疗前HBV-DNA水平的关系。方法接受并完成NA治疗和随访的慢性乙型肝炎患者69例,按治疗前HBV-DNA水平分为高复制组(HBV-DNA>1×105 copies/mL)28例,中复制组(HBV-DNA>1×104～1×105copies/mL)23例,低复制组(HBV-DNA<1×104 copies/mL)18例,比较3组NA停药后的复发率,分析停药复发HBV-DNA水平与治疗前水平间关系。结果停药随访期间30例患者复发,复发率43.47%,复发时间(20.83±14.39)周;高复制组复发率64.29%,中复制组34.78%,低复制组为22.22%,各组间比较差异均有统计学意义(P<0.05);NA治疗停药后3组复发者复发时HBV-DNA载量水平与治疗前比较差异均无统计学意义(P>0.05);治疗前HBV-DNA载量水平和复发时HBV-DNA载量水平呈正相关(r=0.80,P<0.05)。结论 NA治疗前HBV-DNA水平与停药后复发密切相关,HBV-DNA高复制者NA治疗时间需进一步延长。Objective To explore the relationship of pretreatment HBV-DNA load level with withdrawal relapse rate and HBV-DNA level after reaching the cessation criteria in patients with chronic hepatitis B（CHB） treated with nucleos（t）ide analogues（NA）.Methods Sixty-nine patients were completed NA therapeutic courses and follow-up survey.According to the HBV-DNA duplication activity,these patients were divided into three groups,high duplication group（HBV-DNA1×105copies/mL,n=28）,middle duplication group（HBV-DNA1×104 to 1×105 copies/mL,n=23）,and low duplication group（HBV-DNA1×103 copies/mL,n=18）.The relapse rate was evaluated and compared in these three groups.The relationship between the relapse HBV-DNA level and the baselines was analyzed.Results Among the 69 patients,30 patients relapsed（43.47%） with the average relapse duration of（20.83±14.39） weeks after NA withdrawal.The relapse rates were 64.29%,34.78% and 22.22% in high,middle and low duplication groups respectively,which showed significant differences in these three groups（P0.05）.There were no significant differences in HBV-DNA load levels in all these groups at relapse compared with before treatment（P0.05）.The pretherapeutic HBV-DNA loads were positively correlated with the HBV-DNA loads at relapse（P0.05）.Conclusion The pretreatment HBV-DNA load level is closely correlated with the relapse,so the patients with active HBV duplication should receive a long-term NA antiviral therapy.

关 键 词：慢性乙型肝炎 核苷(酸)类似物 停药 复发 HBV-DNA载量水平 

分 类 号：R512.62[医药卫生—内科学]