慢性乙型肝炎核苷类药物停药后复发临床特点.docVIP

慢性乙型肝炎核苷类药物停药后复发临床特点【摘要】 目的:研究慢性乙肝患者停用核苷类药物后复发的临床特点。方法:对核苷类药物停药后复发的慢性乙肝64例，分析其临床诊断、药物种类、疗程、疗效、停药原因、时间及复发后生化及病毒、免疫等指标变化。结果64例中停药前服用拉米夫定49例，阿德福韦酯4例，拉耒夫定换用阿德福韦酯6例，恩替卡韦5例。疗程3个月至5年，停药前获得完全应答10例(15.6％)，部分应答43例(67.2％)，无应答11例(17.2％)。自行停药为52例(81.2％)。于停药后1个月至2年半复发，2年累积复发率90.6％。50例(78.1％)肝损害较前加重，55例(85.9％、)HBV-DNA≥4x10?4 copies／L，39例(60.9％)再次行抗病毒治疗。结论核苷类药物停药复发特点：①大部分未按照相关指南用药和停药，停药前多数未实现完全应答.②因经济条件受限自行停药居多。③多在2年以内复发。④复发后肝损害偏重。⑤复发后病毒复制水平高，一丰以上患者需再次抗病毒治疗。建议慢性乙肝使用核苷类药物治疗应严格依照有关指南用药，强碉长期用药以维持稳定效应。 【关键词】慢性乙型肝炎；核苷类药物；抗病毒治疗；停药复发 After the chronic hepatitis B nuclear glucoside class medicine stops the medicine, recurs clinical characteristic XiaoRenfei ChenXinghao 【Abstract】Goal: The clinical characteristic which after studying the chronic hepatitis B patient to stop using nuclear glucoside class medicine, recurs. Method: Stops the medicine after the nuclear glucoside class medicine recurs the chronic hepatitis B 64 examples, after analyzing its clinical diagnosis, the medicine type, the treatment course, the curative effect, stop the medicine reason, the time and the recrudescence, target changes and so on biochemistry and virus, immunity. Before the result 64 examples stops the medicine, to take the Lami husband to decide 49 examples, the Arab League German luck Wei ester 4 examples, pull the Lei husband to use in exchange the Arab League German luck Wei ester 6 examples surely, graciousness for the card Wei 5 examples. The treatment course 3 months to 5 years, before stopping the medicine, to obtain reply completely 10 examples (15.6%), the part replies 43 examples (67.2%), does not have replies 11 examples (17.2%). Stops the medicine is voluntarily 52 examples (81.2%). Yu Tingyao recurs the latter 1 month to 2-and-a-half years, 2 year accumulation recurrence rate 90.6%. before 50 example (78.1%) liver harm aggravates, 55 examples (85.9%,) HBV-DNA≥4x104 copies/L,39 example (60.9%) once more line of anti-virus treatment. The conclusion nuclear glucoside class medicine st