拉米夫定作为首个核苷类抗病毒药物,具有给药方便、疗效明确的优点,但长期应用耐药率会上升,病毒变异等问题逐渐显现出来。因此,如何在抗病毒前预测拉米夫定抗病毒的疗效至关重要。本文从患者血清HBVDNA水平、HBeAg和HBcAg滴度、ALT水平、机体免疫状态、肝脏病理特点,以及宿主遗传背景等预测因素上进行简要综述,为临床医师选择抗病毒药物提供参考。 Lamivudine, as the first nucleoside antiviral drug, has the advantages of convenient administration and definite curative effect, but the long-term application rate of drug resistance will rise and the problems of virus mutation will gradually appear. Therefore, how to predict the efficacy of antiviral lamivudine before antivirus is crucial. This review summarizes the predictive factors such as serum HBVDNA level, HBeAg and HBcAg titer, ALT level, immune status, liver pathological characteristics, and host genetic background, which provide reference for clinicians to choose antiviral drugs.