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阿德福韦酯单药挽救治疗对拉米夫定耐药的慢性乙型肝炎患者3年疗效观察

宋闽宁 黄文琪 闵峰 洪美珠 范荣华 吴卫兵 张丽

引用本文:
Citation:

阿德福韦酯单药挽救治疗对拉米夫定耐药的慢性乙型肝炎患者3年疗效观察

基金项目: 

军区医学科技创新课题(09MA061); 

详细信息
  • 中图分类号: R512.62

The efficacy of 3 years adefovir monotherapy in chronic hepatitis B patients with lamivudine resistance

Research funding: 

 

  • 摘要: 目的总结阿德福韦酯(ADV)单药挽救治疗拉米夫定(LAM)耐药慢性乙型肝炎患者效果,分析疗效影响因素,探讨单药挽救LAM耐药的可行性。方法 60例慢性乙型肝炎应用LAM耐药后入组挽救治疗。收集患者的基本特征:如年龄、性别、肝生化指标、HBV DNA及HBV M。纪录治疗持续时间及应答,并进行分组对照。结果 60例中,HBV DNA定量反弹≥1log10拷贝/ml 20例,HBV DNA测序rtM204I/V、rtL180M位点变异40例。生化学突破的LAM耐药患者,给予ADV单药治疗。完成156周治疗者42例。HBV DNA低复制组(基线水平HBV DNA 103~105拷贝/ml)治疗后第12至156周HBV DNA转阴率均为80.0%,高复制组(基线水平HBV DNA≥106拷贝/ml)转阴率为40.7%~44.7%,两组相比差异有统计学意义(P<0.01)。HBV DNA转阴率随治疗时间延长渐增加。治疗156周时,HBeAg阳性血清学转换率24.1%。4例因检测出rtA181V/I/S位点变异改用恩替卡韦(ETV)。结论 ADV单药挽救治疗LAM耐药慢性乙型肝炎,具有一定的...

     

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  • 出版日期:  2012-01-20
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