动态观察拉米夫定治疗慢性乙型肝炎患者血清LHBs水平的临床价值  

Dynamic observation of lamivudine in the treatment of LHBs in serum in patients withchronic hepatitis and its clinical value

作　　者：孔德华 韦志平 

机构地区：[1]江苏南京市高淳人民医院,江苏南京211300

出　　处：《河南中医》2014年第B11期177-178,共2页Henan Traditional Chinese Medicine

摘　　要：目的探讨拉米夫定治疗慢性乙型病毒性肝炎期间,患者血清LHBs 水平的动态变化与疗效的关系.方法：51 例慢性乙型肝炎患者,给予口服拉米夫定100mg/d,疗程18 个月.根据治疗结束时的疗效分为无效组（21 例）、部分应答组（20 例）和完全应答组（10 例）.分别以ELISA 法、时间分辨免疫荧光分析法、实时荧光定量PCR 法和DNA 测序法检测所有患者治疗前、治疗后3、6、9、12、18 个月血清LHBs、HBV-M、HBV DNA 拷贝数和YMDD 变异.结果：不同疗效组血清LHBs水平与HBV DNA 拷贝数呈正相关,相关系数均大于0.9;9 例YMDD 变异患者血清LHBs 升高,与变异前相比差异具有显著性（t=3.422,P=0.09）;不同疗效组在治疗期间血清LHBs 均有下降趋势,治疗6 个月后完全应答组、部分应答组和无效组血清LHBs OD 值分别小于0.5、介于0.5 至1.0 之间和大于1.0.结论：患者治疗期间血清LHBs的动态变化可以预测拉米夫定的疗效和作为临床HBV YMDD 变异的监测指标.ObjectiveTo study during lamivudine in treatment of chronic viral hepatitis b, LHBs level in serum of patients with dynamic change and clinical relationship.Methods：51 cases of patients with chronic hepatitis b, lamivudine oral 100mg/d, course of 18 months. Based on invalid at the end of the treatment effect is divided into groups （21cases）, partial response Group （20 cases） and fully answer groups （10 cases）. Respectively by the ELISA method, time-resolved immunofluorescence analysis by real-time fluorescencequantitative PCR and DNA sequencing to detect all patients before treatment, after treatment of 3, 6, 9, 12, 18 months LHBs, HBV-M, number of copies of HBV DNA in serum andYMDD variation. Results：different effect group serum LHBs level and HBV DNA copies number is are related, related coefficient are is greater than 0.9; 9 cases YMDD variationpatients serum LHBs rise, and variation Qian compared differences has significantly sexual （t=3.422,P=0.09）; different effect group in treatment during serum LHBs are has declinetrend, treatment 6 months Hou full answer group, and part answer group and invalid group serum LHBs OD value respectively is less than 0.5, and between 0.5 to 1 Zhijian and isgreater than 1. Conclusion：during treatment of patients with serum LHBs can predict the effect of lamivudine on dynamics of change and as an indicator of HBV YMDD variation inclinical monitoring.

关 键 词：乙型肝炎 慢性 外膜大蛋白 拉米夫定 

分 类 号：R512.6[医药卫生—内科学]