替比夫定治疗HBeAg 阳性慢性乙型肝炎近期疗效及其影响因素分析.docVIP

替比夫定治疗HBeAg阳性慢性乙型肝炎 近期疗效及其影响因素分析 郑玲 潘晨 李芹 姚履芬 （福建医科大学附属传染病医院，福建，福州，350025 ） 摘 要：目的 评价替比夫定治疗HBeAg阳性的慢性乙型肝炎（CHB）52周的疗效和影响因素。方法 67例核苷类似物初治的HBeAg阳性的慢性乙型肝炎患者，接受52周替比夫定（600mg/d）治疗。观察治疗前后血清HBV DNA、ALT水平、HBeAg血清转换率和耐药的变化。同时探讨治疗前HBV DNA水平和HBsAg滴度、治疗12周、24周的HBV DNA水平对52周疗效的预测作用。 结果 治疗12周时，患者血清HBV DNA水平下降4.31㏒10拷贝/ml，52周时下降5.1㏒10拷贝/ml，与治疗前比较明显下降，差异均有统计学意义（P＜0.001）。治疗基线时HBV DNA8.0 ㏒10≥8.0㏒10㏒10≥4㏒10㏒10≥2.48㏒10在治疗前HBV DNA＜8㏒10㏒10㏒10。 关键词 慢性乙型肝炎（CHB）；替比夫定（LDV）；疗效 Analysis of the short-term efficacy and the influencing factors of Telbivudine on patients with HBeAg-positive chronic hepatitis B Zheng ling;Pan chen;Li qing;Yao lv-feng Fuzhou municipal infectious disease hospital, Infectious disease hospital,Fujian Medical University. Fuzhou 350025, China. Corresponding author: panchen , E-mail: panchen999@ 【Abstract】Objective:To analysis the short-term eff and the influencing factors of Telbivudine on hepatitis e antigen (HbeAg)-positive chronic hepatitis B patients. Methods: We conducted a 52w trial of Telbivudine in 67 HBeAg-positive chronic hepatitis B patients，All patients who had not been treated with oral nucleoside analogue were assigned to receive 600mg of lamivudine per day. The change of serum HBV DNA levels，alanine aminotransferase(ALT), HBeAg seroconversion (loss of HBeAg, development of antibody to HBeAg, and undetectable HBV DNA) and genotypic mutations were abserved during the study. To evaluate the contribution of serum HBV DNA level and HBsAg titer at the baseline、serum HBV DNA at 12w24w to predict the efficacy of the treatment. Results: At 12w and 24w, the serum HBV DNA level decreased average at 4.31㏒10 and 5.1㏒10 respectively, there was significant difference compared to the baseline(P0.001). There was no significant difference in HBV DNA decrease and HBeAg seroconversion after completing the assigned treatment regimen between the patients whose serum HBV DNA108copies/ml and ≥108copies/ml (P0.05) at the baseline. There was significant difference in unde