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拉米夫定(lamivudine)是核苷类抗病毒药,具有抑制乙型肝炎病毒(HBV)逆转录酶的作用。该药进入肝细胞内形成三磷酸衍生物,作用于HBV聚合酶,阻止HBV-DNA的合成;可以减少体内的病毒含量,促使HBeAg,抗-HBe血清转换,同时改善肝坏死和肝硬化的作用。目前据国内外多项研究报道,其不良反应发生率低且症状轻微,病人的耐受性较好。1992年以来,经Ⅲ期临床研究和以往的报道证实,在单独使用拉米夫定或联合其它抗病毒药物的过程中,会出现一些少见的不良反应。本文仅讨论在乙型肝炎治疗中出现的耐药现象以及一些少见的不良反应,现综述如下:
Lamivudine is a nucleoside antiviral that has the effect of inhibiting hepatitis B virus (HBV) reverse transcriptase. The drug into the liver cells to form triphosphate derivatives, acting on the HBV polymerase, to prevent the synthesis of HBV-DNA; can reduce the virus content in vivo to promote HBeAg, anti-HBe serum conversion, while improving liver necrosis and cirrhosis . At present, according to a number of studies at home and abroad, the incidence of adverse reactions is low and the symptoms are mild, the patient’s tolerance is better. Since 1992, Phase III clinical studies and previous reports confirm that there are some rare adverse reactions that occur when lamivudine is used alone or in combination with other antiviral drugs. This article discusses only the emergence of drug resistance in hepatitis B treatment and some rare adverse reactions, are summarized as follows: