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目的探讨拉米夫定治疗慢性乙型肝炎的疗效以及耐药观察。方法220例患者,采取拉米夫定治疗,分别于治疗3个月、6个月、12个月、24个月和停药3个月、6个月观察ALT复常率,HBV-DNA转阴率及HBeAg转阴率,同时将该组病例分为轻度,中度,重度慢性乙型肝炎患者进行耐药性的观察。结果拉米夫定治疗24个月时患者血清的HBV-DNA及HBeAg转阴率为别为51.4%,25.9%,ALT复常率56.4%;停药6个月后患者血清的HBV-DNA及HBeAg阳转率为别为26.1%,17.4%,ALT异常率21.7%。耐药观察显示从治疗6个月时开始出现耐药,并且随着治疗时间的延长而逐渐增加。结论拉米夫定能够有效抑制HBV-DNA的复制,可降低ALT,改善临床症状。大多病人能耐受,不良反应少,长期服用是安全的。部分病人产生耐药,停药可反跳。
Objective To investigate the curative effect and drug resistance of lamivudine in the treatment of chronic hepatitis B Methods A total of 220 patients were treated with lamivudine. The rate of ALT abnormalities, the rate of HBV DNA transfection Negative rate and negative rate of HBeAg, at the same time, the patients were divided into mild, moderate and severe chronic hepatitis B patients to observe the drug resistance. Results Serum HBV-DNA and HBeAg negative rates in patients treated with lamivudine for 24 months were 51.4% and 25.9%, respectively. The ALT normalization rate was 56.4%. Serum HBV-DNA HBeAg positive rate was 26.1%, 17.4%, ALT abnormal rate of 21.7%. Drug resistance showed resistance from the 6th month of treatment and gradually increased with treatment duration. Conclusions Lamivudine can effectively inhibit HBV-DNA replication, reduce ALT and improve clinical symptoms. Most patients can tolerate less adverse reactions, long-term use is safe. Some patients have resistance, withdrawal can rebound.