拉米夫定初治慢性乙型肝炎患者早期病毒学应答的影响因素

Influential factors of early virological response for Lamivudine to treat chronic hepatitis B patients

目的探讨拉米夫定初治慢性乙型肝炎患者早期病毒学应答的影响因素。方法选择2001年6月至2012年2月期间就诊我院门诊的慢性乙型肝炎患者270例,接受拉米夫定治疗至少24周。所有患者每2周随访1次,直至24周,记录患者的一般临床资料,治疗基线时的肝功、HBV DNA定量、HBeAg阳性与否,以及每次随访时的HBV DNA定量情况。采用Cox回归模型分析拉米夫定初治慢性乙型肝炎患者早期病毒学应答的影响因素。结果达到早期病毒学应答的患者178例(65.9%),未达到早期病毒学应答患者92例(34.1%)。Cox回归模型分析结果显示:性别、AST值、基线HBV DNA定量是拉米夫定初治慢性乙型肝炎患者早期病毒学应答的有效预测因素。结论影响拉米夫定初治慢性乙型肝炎患者早期病毒学应答的主要因素有:性别、AST值、基线HBV DNA定量。

Objective To analyse the influential factors of early virological response for Lamivudine to treat chronic hepatitis B patients. Methods A total of 270 chronic hepatitis B patients in Fuzhou municipal infectious disease hospital from June 2001 to February 2012 were enrolled in the study prospectively. All patients who had not treated with oral nucleoside analogue were assigned to receive 100 mg of lamivudine per day, and they were followed up every two weeks until 24th week. The clinical features, liver function, HBV DNA quantitative, positive or negative of HBeAg at baseline were recorded. The HBV DNA quantitative was recorded at all the follow-up time. The influential factors of early virological response for Lamivudine to treat chronic hepatitis B patients were analyzed by the Cox proportional hazard model. Results Early virological response occurred on 178 patients （65.9%）, while it didn＇t occur on 92 patients （34.1%）. The result of the Cox proportional hazard model was that gender, AST, HBV DNA quantitative were the predictors for early virological response of Lamivudine to treat chronic hepatitis B patients. Conclusion The chronic hepatitis B patients who are female with high AST, low HBV DNA quantitative may have good therapeutic effect of Lamivudine.