基线ALT对阿德福韦酯治疗HBeAg阴性慢性乙型肝炎疗效影响.docVIP

基线ALT对阿德福韦酯治疗HBeAg阴性慢性乙型肝炎疗效影响 　　[摘要] 目的 探讨基线ALT对阿德福韦酯（ADV）治疗HBeAg阴性慢性乙型肝炎（CHB）疗效的影响。 方法 根据基线ALT，将我院2010年6月～2013年1月门诊收治的55例HBeAg阴性CHB患者分为A、B两组，A组34例，2倍正常上限（2 ULN）≤基线ALT0.05）。各阶段完全病毒学应答率（0.05）。生化应答率：A组为55.9%、76.5%、94.1%、100.0%，B组为57.1%、76.2%、95.2%、94.4%，两组比较差异无统计学意义（P0.05）。治疗过程中，两组均未见HBsAg转阴或血清学转换，未出现耐药。 结论 基线ALT≥2 ULN时，ADV疗效不因基线ALT的升高而进一步提升，基线ALT水平对ADV疗效的影响有限。 　　[关键词] 慢性乙型肝炎；核苷（酸）类；阿德福韦酯 　　[中图分类号] R512.6+2 [文献标识码] A [文章编号] 1674-4721（2016）03（c）-0035-04 　　[Abstract] Objective To explore the impact of baseline ALT on adefovir dipivoxil（ADV） in treating HBeAg negative chronic hepatitis B（CHB）. Methods 55 cases of HBeAg negative CHB patients admitted to our hospital from June 2010 to January 2013 were divided into group A and group B according to the baseline ALT.34 cases were in group A，whose baseline ALT were larger than 2 times normal upper limit（2 ULN），but less than 5 ULN.21 cases were in group B，whose baseline were greater than or equal 5 ULN.All patients were used ADV for treatment.The HBV DNA，HBV marker and ALT were rechecked every 3 months.The data that treated for 3，6，12 and 24 months were selected for comparing and analysis. Results The decreased degree of HBV DNA （lg value） in group A after treatment for 3，6，12 and 24 months was respectively 3.3±1.3、3.7±1.1、4.0±1.1、4.1±1.0，which was respectively 3.5±1.5，3.9±1.4，4.1±1.4 and 4.2±1.3 in group B，and the difference was statistical significance when compared at each stage.Complete virological response rate（0.05）.Biochemical response rates in group A was respectively 55.9%，76.5%， 94.1% and 100.0%，which was respectively 57.1%，76.2%，95.2% and 94.4% in group B，and the difference had no statistical significance（P0.05）.During treatment，any HBsAg overcast or seroconversion were seen between two groups，and drug resistant also not appeared. Conclusion When baseline ALT is greater than or equal 5 ULN，effects of ADV not further increase with the rising of baseline ALT.The level of baseline ALT has limit impact on the effe