阿德福韦酯治疗E抗原阳性慢性乙型肝炎的疗效及其影响因素

Efficacy of Adefovir dipivoxil for patients with HBeAg positive chronic hepatitis B and its influencing factor

目的观察国产阿德福韦酯(ADV)治疗HBeAg阳性慢性乙型肝炎的临床疗效并分析影响疗效的相关因素。方法收集2005年6月至2011年9月在我院采用国产ADV治疗的118例HBeAg阳性慢性乙型肝炎患者临床资料,观察48周时的疗效,分析治疗前ALT水平、HBVDNA水平、体重指数(BMI)及年龄等因素与疗效的相关性。结果 ADV治疗48周时,ALT复常率为88%;HBVDNA转阴率为43.22%;22.03%的患者E抗原消失,其中18.64%的患者发生E抗体血清学转换;耐药率为0。获得HBVDNA转阴者较未获得转阴患者基线ALT水平较高、HBVDNA载量较低、年龄较轻、BMI较小、24周获得初始病毒学应答(IVR)比例更高。结论国产ADV可以有效地抑制HBVDNA复制、改善肝功能,促进HBeAg血清学转换。血清HBVDNA水平较低、ALT水平较高、BMI较低及年龄较轻的患者更易对ADV标准治疗方案产生疗效。

Objective To observe the efficacy of domestic adefovir dipivoxil （ADV） in the treatment of pa- tients with HBeAg positive chronic hepatitis B, and analyze related factors of the curative effect. Methods A total of 118 ttBeAg positive chronic hepatitis B patients were collected from 2005 June to 2011 September in our hospital. They were treated with domestic ADV for 48 weeks. The clinical data was collected. The efficacy was observed and the relevance of therapeutic and factors such as ALT level, HBV DNA level, body mass index （BMI） and age before treatment were analyzed. Results After 48 weeks, ALT recovery rate was 88%; HBV DNA negative rate was 43.22%, 22.03% patients＇ E antigen lost, 18.64% of which occurred E antibody serological conversion, and the resis- tant rate was 0. The patients with HBV DNA negative conversion had higher baseline ALT levels, lower HBV DNA load, smaller BMI, higher percentage of obtaining Initial virologic response （1VR） at 24 weeks, and they were young- er. Conclution Domestic ADV can effectively inhibit HBV DNA replication, improve liver function, and promote HBeAg serological conversion. The patients with lower levels of serum HBV DNA, higher ALT levels, lower BMI. Younger patients has higer efficacy to ADV standard treatment.