摘要
目的评价单用拉米夫定(下称单用组)和胸腺肽、拉米夫定联合(下称联合组)治疗后血清病毒学应答的持久性。方法92例CHB患者:单用组47例平均疗程19.1月(12-44月);联合组45例平均疗程16.8月(12-29月),其中序贯治疗33例,同时治疗12例。获得HBeAg血清转换,HBVDNA<103拷贝/ml,ALT复常者,继续用拉米夫定单用组平均7.5月(1-22月),联合组平均8.9月(1-20月)。停药后随访时间单用组平均28.6月(9-50月),联合组平均27.6月(9-47月)。结果拉米夫定治疗后随访2年余,单用组和联合组HBeAg血清转换的持久应答率分别为78.6%和88.1%(P>0.05),HBV DNA的持久应答率分别为61.7%和71.1%(P>0.05),ALT的持久应答率为66.0%和73.3%(P>0.05)。经拉米夫定治疗后(特别是联合组)HBV DNA在6个月内阴转者与持久应答率明显相关。而治疗前ALT水平、HBeAg和HBV DNA载量高低,性别、临床类型、感染途径和拉米夫定疗程长短及HBeAg血清转换后继续用药时间长短等均与持久应答率无关。结论拉米夫定治疗获得HBeAg血清转换后停药随访2年余,大部分病人的疗效是持久的,仍有30%-40%的病例复发,联合胸腺肽治疗亦不能明显降低复发率。
Objective To appraise the persistence of serum virology response after the patients with chronic hepatitis B is treated with Lamivudine （alone group） or Lamivudine combined with Thymosin （combined group ）. Methods 92 patients with CHB were randomly divided into two groups. 47 cases were enrolled receive Lamivudine alone. The average therapeutic course is 19.1 （12 -44） months. 45 cases were enrolled in the combined therapy group. The average therapeutic course is 16.8（ 12 -29 ） months. 33 cases of combined group were enrolled receive siquantial therapy. 12 cases of combined group were enrolled receive simultaneous therapy（ Lamivudine and Thymosin ）. The patients in two groups whose HBeAg have procured seroconversion, HBVDNA 〈 10^3 copies/ml and ALT recovered to normal,were treated continuously with Lamivudine. The average course of treatment is 7.5 （ 1 - 22 ） months in alone group and 8.9 （ 1 - 20 ） in combined group. The follow - up period is 28.6 （9 - 50 ） months in alone group and 27.6 （9 - 47 ） months in combined group after withdrawal on average. Results Two years after treatment, the enduring response rate of seroconversion is 78.6% and 88.1% in alone group and combined group respectively （ P 〉 0.05 ）. The enduring response rate of ALT is 66.0% and 73.3% in two groups respectively （ P 〉 0.05） . The enduring response rate of HBVDNA is 61.7% and 71.1% in two groups respectively （P 〉 0. 05 ）. After the treatment with lamivudine, the comparison between those whose HBVDNA reduced to negative state within and over six months shows difference in the enduring response rate of HBVDNA, especially so in the combined group. Gender, age, clinical type, route of infection, pretherapy ALT level, HBeAg titre, HBVDNA capacities, therapeutic course, the course of continuous treatment with Lamivudine after HBeAg have procured seroconversion etc. are not correlated with the enduring response rate. Conclusions Followed up after two years, we find that most patients＇ curat
出处
《医学研究杂志》
2007年第1期75-77,共3页
Journal of Medical Research
