论文部分内容阅读
目的研究核苷(酸)类似物(NAs)治疗慢性乙型肝炎(CHB)的耐药趋势,指导临床用药。方法回顾性分析2006年至2009年3年NAs疗程中496例CHB患者HBV基因型、耐药特征及其分布、变化趋势。结果 3年共检出耐药变异株243例(48.99%),第一、二、三年耐药检出率分别为48.33%(58/120)、49.64%(69/139)和48.95%(116/237),拉米夫定耐药株检出率分别为45.0%(54/120)、44.6%(62/139)和36.7%(87/237),阿德福韦耐药株检出率分别为1.67%(2/120)、2.16%(3/139)和7.59%(18/237),恩替卡韦耐药株检出率分别为0.83%(1/120)、0.72%(1/139)和1.69%(4/237),多重耐药株检出率分别为0.83%(1/120)、2.16%(3/139)和2.95%(7/237)。其中阿德福韦耐药株及多重耐药株检出率有明显的逐年增加趋势(P<0.05)。结论随着NAs疗程的延长,NAs耐药变异株检出率,尤其是阿德福韦耐药株及多重耐药株检出率逐年增加。
Objective To study the drug resistance trends of nucleoside analogues (NAs) in the treatment of chronic hepatitis B (CHB) and guide the clinical use of drugs. Methods A retrospective analysis of HBV genotypes, drug resistance, distribution and trends of 496 CHB patients during 3 years of NAs from 2006 to 2009 was retrospectively analyzed. Results A total of 243 resistant strains (48.99%) were detected in the first, second, and third years. The detection rates were 48.33% (58/120), 49.64% (69/139) and 48.95% 116/237). The detection rates of lamivudine-resistant strains were 45.0% (54/120), 44.6% (62/139) and 36.7% (87/237), respectively. Adefovir-resistant strains were detected Rates were 1.67% (2/120), 2.16% (3/139) and 7.59% (18/237) respectively. The detection rates of entecavir resistant strains were 0.83% (1/120) and 0.72% (1/139 ) And 1.69% (4/237) respectively. The detection rates of multidrug resistant strains were 0.83% (1/120), 2.16% (3/139) and 2.95% (7/237) respectively. Among them, the detection rate of adefovir-resistant strains and multi-drug-resistant strains increased obviously year by year (P <0.05). Conclusions With the prolongation of NAs, the detection rate of NAs resistant strains, especially adefovir and multidrug resistant strains has been increasing year by year.