影响拉米夫定治疗慢性乙型肝炎持续性病毒学应答因素的Cox回归分析

目的通过Cox回归分析，探讨影响拉米夫定治疗慢性乙型肝炎持续性病毒学应答的相关因素。方法回顾性和前瞻分析72例应用拉米夫定治疗的慢性乙型肝炎患者的临床、实验室检查及HBV基因型资料。将基线ALT水平、基线病毒载量等10个可能影响因素用Cox比例风险模型进行单因素和多因素分析。结果基线ALT水平（X4）、基线病毒载量（X5）、应答时间（X8）及疗程（X9）是拉米夫定持续性病毒学应答的独立影响因素，得回归方程为：h（t）=hO（t）·exp（-0．488X4＋0．332X5＋1．309X8-5．480X9）。结论获得早期病毒学应答、基线病毒载量低、治疗前ALT水平高和治疗疗程较长的慢性乙型肝炎患者在拉米夫定治疗后有望获得持久的病毒学应答。

Cox proportional hazard model analysis of influence factors to sustained virological response to lamivudine therapy in patients with chromic hepatitis B

Objective To probe the influence factors to sustained virological response to lamivudine therapy in patients with chronic hepatitis B. Methods 72 consecutive patients with chronic hepatitis B who were treated with lamivudine for at least 1 year were retrospectively investigated. 10 probable influence factors to lamivudine treatment were analyzed with univariate and multivariate Cox regression model. Results Baseline ALT,HBV DNA,initial virologic responses and duration of treatment were predictive of sustained responses. Conclusions Patients with long treatment duration,early virological responses,higher baseline ALT levels and lower baseline HBV DNA load are most likely to obtain sustained virological response to lamivudine therapy.