影响阿德福韦酯治疗慢性乙型肝炎疗效的临床因素分析
投稿时间:2017-03-01  修订日期:2017-03-07  点此下载全文
引用本文:于海滨,丁惠国.影响阿德福韦酯治疗慢性乙型肝炎疗效的临床因素分析[J].医学研究杂志,2017,46(6):63-67
DOI: 10.11969/j.issn.1673-548X.2017.06.017
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作者单位E-mail
于海滨 100069 首都医科大学附属北京佑安医院肝病消化中心一病区  
丁惠国 100069 首都医科大学附属北京佑安医院肝病消化中心一病区 dinghuiguo@medmail.com.cn 
基金项目:国家自然科学基金资助项目(31400761);北京市自然科学基金资助项目(7142079)
中文摘要:目的 通过回顾临床病例,分析阿德福韦酯治疗慢性乙型肝炎患者52周的疗效及预测因素。方法 对慢性乙型肝炎患者进行阿德福韦酯抗病毒治疗并收集临床化验指标,52周时评估疗效,分析慢性乙型肝炎患者不同疗效组年龄、性别、肝功能、HBV DNA定量、血细胞等指标的差异。结果 4周时应答佳组HBV DNA log10水平(2.48±0.45)低于应答不佳组(4.72±0.28),4周时应答佳组HBV DNA下降的log10值(3.31±0.36)大于疗效不佳组(1.54±0.44);12周时应答佳组HBV DNA水平log10(0.80±0.27)低于应答不佳组log10(4.63±0.43),12周时疗效佳组下降HBV DNA下降log10值(4.99±0.39)大于疗效不佳组(1.18±0.60),12周时疗效佳组红细胞[(4.50±0.08)×1012/L]低于疗效不佳组[(6.01±0.13)×1012/L],12周时疗效佳组中性粒细胞[(58.38±2.08)×109/L]高于疗效不佳组[(58.38±2.08)×109/L]。两组间比较,差异有统计学意义(P<0.05)。结论Logistic回归分析,12周时HBV DNA下降log10值、红细胞水平为评估52周阿德福韦疗效的独立预测因素,这对于制定慢性乙型肝炎制定个体化治疗方案或许有借鉴作用。
中文关键词:慢性乙型肝炎  阿德福韦酯  预测因素
 
Clinical Predicting Factors of Adefovir Dipivoxil Therapy in Patients with Chronic Hepatitis B
Abstract:Objective To analyze the efficacy and the predictive factors of adefovir dipivoxil (ADV) therapy in patients with chronic hepatitis B(CHB). Methods Fifty two CHB patients were recruited in this study. All patients were treated for 52 weeks. Liver function, blood cell amounts and HBV DNA levels were detected at time course. Results At time point of 4 weeks, the serum HBV DNA level in good response group were significantly less than poor response group(2.48±0.45 log10 vs 4.72±0.28 log10, P<0.05). The decreased log value of HBV DNA in good response group was significantly higher than poor response group(3.31±0.36 vs 1.54±0.44, P<0.05).At time point of 12 weeks,the decreased log value of HBV DNA and neutrophil percent in good response group were significantly higher than poor response group[3.31±0.36 vs 1.54±0.44, (58.38±2.08)×109/L vs (46.90±3.01)×109/L, P<0.05], the serum HBV DNA level and red blood cell level in good response group were significantly less than poor response group[0.80±0.27 log10 vs 4.63±0.43 log10, (4.50±0.08)×1012/L vs (6.01±0.13)×1012/L, P<0.05]. Conclusion The decreased log value of HBV DNA and red blood cell level of 12weeks are the independently predictive factors for adefovir dipivoxil (ADV) therapy in patients with chronic hepatitis B.
keywords:Chronic hepatitis B  Adefovir dipivoxil  Prediction
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