替比夫定治疗HBeAg阳性慢性乙型肝炎疗效的预测指标

The factors predicting the efficacy of telbivudine in the treatment of HBeAg-positive chronic hepatitis B

目的探讨替比夫定治疗HBeAg阳性慢性乙型肝炎(CHB)48周的疗效及其预测指标。方法采用替比夫定(LdT)600 mg/d治疗78例HBeAg阳性CHB患者48周,从性别、年龄、ALT和HBV DNA基线、早期病毒学应答(治疗12周时HBV DNA转阴)为预测因素,分析其对治疗48周疗效的影响。结果性别、年龄与治疗8～48周时HBV DNA转阴无相关性(P>0.05);5 ULN≤ALT≤10 ULN组治疗24、36及48周时HBV DNA转阴率高于2 ULN≤ALT≤5 ULN组(P<0.05,P<0.01);HBV DNA 106～105拷贝/ml组治疗48周时ALT复常率和HBV DNA转阴率高于HBV DNA>107拷贝/ml组(P<0.05);早期病毒学应答组治疗48周时HBeAg阴转率ALT复常率和HBV DNA转阴率也高于非应答组(治疗12周时HBV DNA≥500拷贝/ml)(P<0.05)。结论 ALT、HBV DNA基线、早期病毒学应答可能可以作为预测替比夫定抗HBV疗效的指标。

Objective To study the efficacy of telbivudine in 48-week treatment of HBeAg-positive chronic hepatitis B（CHB） and to find the factors that predict the efficacy of the treatment.Methods 78 patients with HBeAg-positive CHB were treated with Telbivudine,100mg daily for 48 weeks.Their gender,age,ALT and HBV DNA baseline and early virologic response（after 12 weeks of treatment,HBV DNA negative） were selected for predictive factors and their impact on the efficacy of the treatment was analyzed.Results Gender,age had no correlation with HBV DNA negative conversion after treatment for 8,12,24,36 and 48 weeks（P〉0.05）.HBV DNA negative conversion rates after treatment for 24,36 and 48 weeks were higher in 5ULN≤ALT≤10ULN group than those in 2ULN≤ALT≤5ULN group respectively（P〈0.05,P〈0.01）.The ALT normalization rate and HBV DNA negative conversion rate of HBV DNA 106-105copies/ml group were higher than those of HBV DNA 〉107copies/ml group respectively（P〈0.05）.The ALT normalization rate and HBV DNA negative conversion rate of the early virologic response group were higher than those of non-responded group（after treatment for 12 weeks HBV DNA≥500copies/ml） at week 48（P〈0.05）.Conclusion ALT,HBV DNA baseline and early virological response can be used to predict the anti-HBV efficacy of Telbivudine