摘要
目的:探讨慢性乙型肝炎患者停用核苷(酸)类药物后的临床特征及影响因素。方法:收集73例慢性乙型肝炎患者停药后的临床资料,分析影响核苷(酸)类药物停药复发时间的因素。结果:拉米夫定组与联合用药组复发时间比较,患者复发时间较长(P=0.031)。在抗病毒疗程>24个月组,恩替卡韦与联合用药组复发时间比较,患者复发时间较长(P=0.048);拉米夫定组与恩替卡韦组复发时HBV DNA水平比较,恩替卡韦组患者HBV DNA水平较低(P=0.039)。在未达标患者中,抗病毒疗程是影响核苷(酸)类药物停药复发时间的危险因素。结论:大多数患者未达到停药标准而自行停药,已达到停药标准患者,停药后仍有较高复发率。在未达标患者中,抗病毒疗程长,与短时间内复发有关。
Objective：To investigate the clinical features of chronic hepatitis B patients after stopping nucleos（t）ide analogues and related factors for hepatitis B relapse. Methods：We investigated 73 chronic hepatitis B patients who withdrew nucleos（t）ide analogues and analyzed the reasons for withdrawal and related factors for hepatitis B relapse. Results：Those who stopped lamivudine had longer relapse time compared with combination therapy（P=0.031）. Among patients with total treatment duration more than 24 months,those who stopped entecavir had longer relapse time compared with combination therapy（P=0.048）,and lower HBV DNA level while relapsed compared with lamivudine（P=0.039）. The COX proportional hazards model analysis showed that total treatment duration was the risk factor for hepatitis B relapse after stopping nucleos（t）ide analogues with patients who did not achieve cessation criteria.Conclusion：Most patients stopped nucleos（t）ide analogues without achieving cessation criteria. There was a still high relapse rate among patients in spite of they had achieved cessation criteria. The longer antiviral treatment duration was associated with a short time recurrence with those who did not achieve cessation criteria.
作者
史萍
蒋龙凤
韩亚萍
徐菱遥
刘瑶
岳明
李军
Shi Ping;Jiang Longfeng;Han Yaping;Xu Lingyao;Liu Yao;Yue Ming;Li Jun(Department of Infectious Diseases, the First Affiliated Hospital of NMU, Nanjing 210029, China)
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2018年第5期638-642,共5页
Journal of Nanjing Medical University(Natural Sciences)
基金
国家科技重大专项(2013ZXl0002005)
江苏省卫生厅医学创新团队与领军人才培养基金(LJ201121)
中国肝炎基金会天晴肝病研究基金(CFHPC20132071)
关键词
肝炎
乙型
慢性
核苷(酸)类
停药
复发
hepatitis B
chronic
nucleos （t） ide analogues
drug withdrawal
recurrence
