替比夫定治疗慢性乙型肝炎疗效及其影响因素

目的评价替比夫定治疗慢性乙型肝炎52周的疗效及其影响因素。方法采用替比夫定治疗22例慢性乙型肝炎患者52周,对治疗前后ALT、HBVDNA、HBeAg消失、HBeAg血清转换、组织学改善、基因型耐药进行比较。同时根据患者治疗前状况的评估和治疗4周、8周、12周和24周的HBVDNA来预测影响疗效的因素。结果治疗52周,HBV DNA和ALT与治疗前相比明显下降,差异有统计学意义（P〈0．001）。患者治疗前的评估对52周的疗效无明显影响,而治疗24周HBV DNA水平低于300拷贝／ml时,52周HBV检测不到、ALT复常、HBeAg消失和HBeAg血清转换的比例明显增高,基因型耐药明显减少,差异有统计学意义（P〈0．05）。结论替比夫定能明显抑制HBV DNA复制,使ALT复常,促进HBeAg血清转换。治疗24周的HBV DNA抑制水平可预测治疗52周的疗效。

The efficacy of telbivudine treatment in patients with chronic hepatitis B and the factor that predict the efficacy of the treatment

Objective To evaluate the efficacy of telbivudine treatment in patients with chronic hepatitis B and to find the factor that predict the efficacy of the treatment. Methods Twenty two patients treated with telbivudine for 52 weeks, compared the level of ALT, HBV DNA, HBeAg loss, HBeAg seroconversion, genotype resistance, histological change before and after 52 weeks of treatment. Mean while patients were evaluated the status of HBV DNA before and after treatment for 4 weeks, 8 weeks, 12 weeks and 24 weeks, in order to get the factor that can predict the efficacy of the treatment. Results At week 52, the mean level of serum ALT and HBV DNA was significantly lower than that before treatment （P〈0. 001 ）. The degree of suppression HBV DNA lower than 300 copies/ml at week 24 may associate with the efficacy at the week 52 （P〈0.05）, while the HBV DNA status before the treatment seems no effect with efficacy. Conclusion Telbivudine was effective in patients with chronic hepatitis B. The degree of suppression of HBV at week 24 may predict the efficacy of 52 weeks treatment.