拉米夫定治疗慢性乙型肝炎患者138例临床观察

The clinical observation of effect of Lamivudine treating 138 chronic hepatitis B patients

目的研究拉米夫定治疗慢性乙型肝炎的疗效及耐药情况。方法138例患者采用拉米夫定治疗，分别于治疗3mo、6mo、12too、24mo和停药3mo、6mo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、重度慢性乙型肝炎进行耐药性观察。结果拉米夫定治疗24mo时患者血清的HBV-DNA及HBeAg转阴率分别为51．4％、26．1％，ALT复常56．5％，停药6mo后患者血清的HBV-DNA及HBeAgN转率分别为27．6％、17.2％，ALT异常24．1％。耐药观察示从治疗6mo时开始出现耐药，并随治疗时间延长而逐渐增加。结论拉米夫定能够有效抑制HBV-DNA复制，可以降低ALT，改善临床症状，大多数病人能接受，不良反应少，长期服产生耐药，停药后可反弹。

Objective To study the efficacy and drug resistance of Lamivudine for chronic hepatitis B, Methods 138 patients take lamivudine therapy, we observer ALT recovery rate, HBV-DNA negative rate and HBeAg negative rate respectively after the treatment of 3 months, 6 months, 12 months, 24 months and withdrawal 3-month and 6-month.At the same time, the 138 patients are divided into mild, moderate, severe chronic hepatitis B patients groups for drug resistance observation. Results After 24 months of Lamivudine treatment, the serum HBeAg negative rate of patients is 26.1% and HBV DNA-negative rate is 51.4%, ALT recovery rate is 56.5%; withdrawal of drugs for 6 months, the serum HBeAg negative rate of patients is 17.2% and HBV DNA-negative rate is 27.6%, ALT recovery rate is 24.1%.The drug resistance observation showed that after the treatment of six months, the drug resistance began to emerge, and with the extension of time and the drug resistance gradually increase. Conclusions Lamivudine can effectively inhibit the replication of HBV-DNA, can reduce ALT, and improve clinical symptoms. Most patients can tolerate, fewer patients have adverse reactions, and long-term using Lamivudine is safe. Some patients have drug resistance, but withdrawal can jump.