慢性乙型肝炎患者HBV-DNA载量与拉米夫定疗效及YMDD变异相关性研究

The Correlation among Level of Serum HBV-DNA,Efficacy of Lamivudine and YMDD Mutation in Patients with Chronic Hepatitis B

目的:探讨慢性乙型肝炎患者HBV-DNA载量与拉米夫定疗效及YMDD变异的相关性。方法:对69例服用拉米夫定的慢性乙型肝炎患者治疗前的ALT、HBV-DNA水平及治疗48周后的变异情况进行分析。结果:经拉米夫定治疗48周的69例患者中,有19例HBV发生YMDD病毒变异,变异率27.6%。HBV发生YMDD病毒变异与ALT的水平呈负相关;与HBV-DNA载量呈正相关。结论:服用拉米夫定一定严格把握治疗基线,选择最佳治疗时机,这是提高疗效的关键。

Objective：To study the correlation among level of serum HBV-DNA , efficacy of lamivudine and YMDD mutation in patients with chronic hepatitis B. Methods： 69 patients with chronie hepatitis B reeeived lamivudine treatment and the serum level of ALT , HBV-DNA and YMDD mutation were analyzed before and after treatment. Results： In the G9 patients with treatment of lamivudine for 48 weeks, 19 patients were detectable with YMDD mutation, the rate of YMDD mutation in this study was 27. 6% （19/69）. There was inverse correlation between YMDD mutation and level of serum ALT, and positive correlation between YMDD mutation and level of serum HBV-DNA. Conclusions： ALT base line must be taken into consideration when lamivudine treatment is employed and choosing the optimal treatment opportunity was the key to enhancing efficacy.