慢性乙型肝炎抗病毒治疗适应证的变迁  

Evolution in the indications for anti-viral therapy in chronic hepatitis B

作　　者：刘津津 张梦阳 孙亚朦[1] 尤红[1] LIU Jinjin;ZHANG Mengyang;SUN Yameng;YOU Hong(Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院,北京100050

出　　处：《临床肝胆病杂志》2023年第6期1299-1303,共5页Journal of Clinical Hepatology

基　　金：北京市科学技术委员会“首都临床特色诊疗技术研究及转化应用”专项(Z221100007422115)。

摘　　要：为减轻慢性乙型肝炎(CHB)相关疾病负担,提高CHB治疗率,2005—2022年中华医学会发布的《慢性乙型肝炎防治指南》中,抗病毒适应证呈逐渐放宽、简化的趋势。本文旨从HBeAg阳性和阴性CHB抗病毒适应证的趋同、HBV DNA治疗阈值的降低、血清丙氨酸转氨酶治疗阈值的降低、对疾病进展风险因素的重视,以及肝硬化患者病毒学指标要求逐步放宽五个方面来阐述CHB抗病毒治疗适应证的变迁。In order to reduce the disease burden of chronic hepatitis B(CHB)and improve the treatment rate of CHB,the indications for anti-viral therapy have been gradually expanded and simplified in guidelines for the prevention and treatment of CHB released by Chinese Medical Association from 2005 to 2022.This article elaborates on the evolution in the indications for anti-viral therapy in CHB from the five aspects of converging indications of HBeAg-positive and HBeAg-negative CHB,reduction in the treatment threshold of HBV DNA,reduction in the treatment threshold of serum alanine aminotransferase,emphasis on the risk factors for disease progression,and gradual loosening of the requirements for virological indicators in patients with liver cirrhosis.

关 键 词：乙型肝炎 慢性 抗病毒治疗 适应证 

分 类 号：R512.62[医药卫生—内科学]