替諾福韋挽救治療耐藥復(fù)發(fā)的慢性乙型肝炎患者48周療效初探
發(fā)布時(shí)間：2019-05-18 12:05
【摘要】：目的觀察替諾福韋(TDF)單藥或聯(lián)合恩替卡韋(ETV)挽救治療耐藥復(fù)發(fā)的慢性乙型肝炎患者的療效及安全性。方法回顧性分析11例耐藥復(fù)發(fā)的慢性乙型肝炎患者的挽救治療,其中6例患者單用TDF,5例患者采用TDF聯(lián)合ETV。采用時(shí)間分辨免疫熒光法檢測(cè)血清乙型肝炎病毒標(biāo)志物,采用脫氧核糖核酸測(cè)序法檢測(cè)與耐藥相關(guān)的HBV P區(qū)169、173、180、181、184、202、204、233、236、250位耐藥變異,采用PCR-熒光探針?lè)z測(cè)血清HBV DNA載量,采用苦味酸法檢測(cè)血清肌酐(Cr)水平。應(yīng)用Kaplan-Meier分析血清HBV DNA累積不可檢出率。結(jié)果挽救治療前,1例患者檢測(cè)到ADV基因型耐藥,7例患者檢測(cè)到LAM/ETV基因型耐藥,3例患者檢測(cè)到LAM/ETV/ADA基因型耐藥;HBV DNA基線水平為(4.82±1.29)lg IU/ml,挽救治療第4周降至(3.57±0.55)lg IU/ml,第12周降至(2.91±0.37)lg IU/ml,隨訪至第48周,僅1例患者可檢測(cè)出HBV DNA。挽救治療4、12、24和36周,血清HBV DNA累積不可檢出率分別為36.4%(4/11)、63.6%(7/11)、81.8%(9/11)和90.9%(10/11);隨訪結(jié)束時(shí),血清ALT水平由(64.36±34.55)U/L降至(37.7±24.49)U/L;治療期間未發(fā)生腎功能異常或其他不良事件。結(jié)論TDF單藥或聯(lián)合ETV挽救治療耐藥復(fù)發(fā)的慢性乙型肝炎患者仍能較快速地抑制病毒復(fù)制,具有良好的療效和安全性。
[Abstract]:Objective to observe the efficacy and safety of tenofovir (TDF) alone or entecavir (ETV) in the treatment of drug-resistant recurrent chronic hepatitis B. Methods the rescue treatment of 11 patients with drug resistance recurrence of chronic hepatitis B was analyzed retrospectively. among them, 6 patients were treated with TDF,5 alone with TDF combined with ETV.. Serum hepatitis B virus markers were detected by time-resolved immunofluorescence, HBV P region 16917318018181820204233236250 mutation related to drug resistance was detected by deoxyribonucleic acid sequencing, and serum HBV DNA load was detected by PCR- fluorescence probe method. Serum creatinine (Cr) level was measured by picric acid method. The cumulative undetected rate of serum HBV DNA was analyzed by Kaplan-Meier. Results before rescue treatment, ADV genotypic resistance was detected in 1 patient, LAM/ETV genotypic resistance was detected in 7 patients, and LAM/ETV/ADA genotypic resistance was detected in 3 patients. The baseline level of HBV DNA decreased from (4.82 鹵1.29) lg IU/ml, to (3.57 鹵0.55) lg IU/ml, at the 12th week to (2.91 鹵0.37) lg IU/ml, at the 12th week. HBV DNA. could be detected in only one patient. After 4, 12, 24 and 36 weeks of rescue treatment, the cumulative undetected rate of serum HBV DNA was 36.4% (4 鈮，
本文編號(hào)：2479980
[Abstract]:Objective to observe the efficacy and safety of tenofovir (TDF) alone or entecavir (ETV) in the treatment of drug-resistant recurrent chronic hepatitis B. Methods the rescue treatment of 11 patients with drug resistance recurrence of chronic hepatitis B was analyzed retrospectively. among them, 6 patients were treated with TDF,5 alone with TDF combined with ETV.. Serum hepatitis B virus markers were detected by time-resolved immunofluorescence, HBV P region 16917318018181820204233236250 mutation related to drug resistance was detected by deoxyribonucleic acid sequencing, and serum HBV DNA load was detected by PCR- fluorescence probe method. Serum creatinine (Cr) level was measured by picric acid method. The cumulative undetected rate of serum HBV DNA was analyzed by Kaplan-Meier. Results before rescue treatment, ADV genotypic resistance was detected in 1 patient, LAM/ETV genotypic resistance was detected in 7 patients, and LAM/ETV/ADA genotypic resistance was detected in 3 patients. The baseline level of HBV DNA decreased from (4.82 鹵1.29) lg IU/ml, to (3.57 鹵0.55) lg IU/ml, at the 12th week to (2.91 鹵0.37) lg IU/ml, at the 12th week. HBV DNA. could be detected in only one patient. After 4, 12, 24 and 36 weeks of rescue treatment, the cumulative undetected rate of serum HBV DNA was 36.4% (4 鈮，
本文編號(hào)：2479980
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