拉米呋啶治疗HBV携带者血清HBVDNA含量的动态检测及意义

Study of continuously measuring serum HBV DNA level and evaluating its clinical significance in HBV carriers treated by lamivudine

目的 探讨拉米呋啶对HBV携带者的疗效及相应临床意义。方法 1 1 5例HBV携带者中治疗组 70例接受拉米呋啶治疗一年 ,对照组 45例仅做一般护肝治疗。按治疗前血清HBVDNA含量将治疗组分为三组 :>8.0 0组 1 4例 ,6 .0 0～8.0 0组 41例 ,4.0 0～ 6 .0 0组 1 5例 ,分别在疗程的第 3月、6月、9月、1 2月动态检测其血清HBVDNA含量。结果 与对照组相比较 ,治疗组治疗后血清HBVDNA含量显著降低 (P <0 .0 1 ) ,阴转率显著升高 (P <0 .0 1 )。在疗程的第 3月、6月、9月、1 2月 ,4.0 0～ 6 .0 0组 (P <0 .0 1 )和 6 .0 0～ 8.0 0组 (P <0 .0 5)血清HBVDNA含量均显著低于 >8.0 0组 ;4.0 0～ 6 .0 0组血清HBVDNA阴转率均显著高于 >8.0 0组 (P <0 .0 1 ,P <0 .0 5) ,6 .0 0～ 8.0 0组血清HBVDNA阴转率均显著高于 >8.0 0组 (P<0 .0 5)。结论 拉米呋啶的疗效与HBV携带者体内的HBV复制水平密切相关 ,治疗前血清HBVDNA含量低者对拉米呋啶治疗更为敏感。

Objective To explore the therapeutic effect of lamivudine for HBV carriers and evaluate its clinical significance. Methods 115 HBV carriers were divided into the therapeutic group with 70 cases and the control group with 45 people,which were treated by lamivudine and by routine drugs for protecting liver for one year respectively. According to serum HBVDNA levels before therapy,the therapeutic group was divided into three groups:>8.00 group with 14 cases,6.00～8.00 group with 41 cases,4.00～6.00 group with 15 cases.Serum HBVDNA levels in three groups were measured in the therapeutic period of third,sixth,ninth and twelfth month respectively. Results After the therapy, serum HBVDNA level in the therapeutic group was significantly lower than that in the control group(P<0.01),and serum HBVDNA negative rate in the therapeutic group was significantly higher than that in the control group(P<0.01).In the third, sixth, ninth and twelfth month,serum HBVDNA levels in 4.00～6.00 group(P<0.01) and 6.00～8.00 group (P<0.05) were significantly lower than that in >8.00 group,while serum HBVDNA negative rate in 4.00～6.00 group was significantly higher than that in >8.00 group(P<0.01,P<0.05),and serum HBVDNA negative rate in 6.00～8.00 group was significantly higher than that in >8.00 group(P<0.05)respectively. Conclusions The therapeutic effect of lamivudine is tightly correlated with the replication level of HBV in HBV carriers, and the HBV carriers with low serum HBVDNA level may be more sensitive to lamivudine.