拉米夫定治疗HBeAg阳性和阴性慢性乙型肝炎探讨

Discussion of the Treatment of Lamivudine on Chronic Hepatitis B with Positive and Negative HBeAg

目的:探讨HBeAg阳性和阴性慢性乙肝患者经拉米夫定治疗后HBVYMDD变异、HBV DNA消失率、ALT复常率情况。方法:将病例分成两组,HBeAg阳性48例,HBeA阴性48例,均口服拉米夫定100mg/d。治疗前和治疗9个月、12个月、18个月、24个月分别检测血清标本HBVYMDD变异、HBV DNA消失率、ALT复常率。结果:治疗前和治疗9个月两组HBVYMDD变异率无差别(P>0.05);治疗12个月、18个月、24个月两组HBVYMDD变异率均有显著性差异(P<0.05)。治疗前和治疗9个月、12个月、18个月、24个月两组HBV DNA消失率、ALT复常率均无显著性差异(P>0.05)。结论:HBeAg阳性乙肝患者经拉米夫定治疗后较HBeAg阴性患者易发生HBVYMDD变异,但治疗效果无明显差异。

Purpose: To discuss the HBVYMDD variants, the HBV DNA disappearing rate and the ALT recovering rate after the treatment of lamivudine in the chronic hepatitis B patients with positive and negative HBeAg. Methods: 48 chronic hepatitis B patients with positive HBeAg and 48 cases with negative HBeAg were included into two groups respectively. Taking lamivudine 100 mg/d, each patient was tested the HBVYMDD variants, the HBV DNA disappearing rate and the ALT recovering rate before the treatment and 9,12,18 and 24 monthes after it. Results: There is no difference in the HBVYMDD variants between the two groups before the treatment and 9 months after it(P>0.05), but there is significant difference in HBVYMDD variants between the two groups 12, 18 and 24 months after the treatment respectively (P<0.05). There are not significant differences in HBV DAN disappearing rate and ALT recovering rate between the two groups during the whole process(P>0.05). Conclusion: After the treatment of lamivudine, the HBeAg positive patients are more likely to have HBVYMDD variants than the HBeAg negative ones, but there is no significant difference in the treatment result.