發(fā)布時間：2018-07-13 12:42

【摘要】：目的探討分析e抗原陰性慢性乙肝老年患者核苷類藥物停藥后的臨床及病毒學(xué)復(fù)發(fā)情況。方法選取78例e抗原陰性慢性乙肝老年病患展開調(diào)查研究,根據(jù)病患服用藥物的種類分為拉米夫定(LMV)組18例,阿德福韋酯(ADV)組19例,恩替卡韋(ETV)組21例,ETV+ADV組20例,分析病患的臨床癥狀、服用藥物的種類、療程、停藥原因、停藥后的復(fù)發(fā)情況及病毒、血清學(xué)等指標。結(jié)果 LMV組,停藥時間2個月~3年;ADV組,停藥時間2個月~3年;ETV組,停藥時間1個月~2年;ETV+ADV組,停藥時間2個月~1年。停藥6~12個月復(fù)發(fā)人數(shù)明顯多于其他階段復(fù)發(fā)人數(shù),24個月累積復(fù)發(fā)出現(xiàn)的人數(shù)較多,對比差異顯著(P0.05),慢性中度肝炎病患復(fù)發(fā)34例,慢性重度肝炎病患復(fù)發(fā)22例,慢性重型肝炎病患復(fù)發(fā)11例,代償性肝硬化復(fù)發(fā)7例,4例失代償性肝硬化復(fù)發(fā)4例。慢性重度肝炎病患和慢性重型肝炎患者ALT、AST、凝血酶原時間(PT)指標都明顯比其他組高(P0.05)。結(jié)論 e抗原陰性慢性乙肝老年病患核苷類藥物停藥后多在6~12個月以內(nèi)復(fù)發(fā),復(fù)發(fā)后對肝造成的損傷更嚴重。醫(yī)護人員應(yīng)根據(jù)病患的實際情況指導(dǎo)用藥,以獲得穩(wěn)定的效果。
[Abstract]:Objective to investigate the clinical and virological recurrence of nucleoside drugs in elderly patients with chronic hepatitis B with negative e antigen. Methods Seventy-eight elderly patients with chronic hepatitis B with negative e antigen were divided into lamivudine (LMV) group (n = 18), adefovir ester (ADV) group (n = 19) and entecavir (ETV) group (n = 21). The clinical symptoms, the kinds of drugs taken, the course of treatment, the reasons of withdrawal, the relapse after withdrawal, the virus, serology and so on were analyzed. Results in the LMV group, the withdrawal time was 2 months ~ 3 years, the withdrawal time was 1 month ~ 2 years, and the withdrawal time was 2 months ~ 1 year. The number of relapses in 6 ~ 12 months after withdrawal was significantly higher than that in other stages, and the cumulative recurrence in 24 months was more than that in other stages (P0.05). 34 patients with chronic moderate hepatitis and 22 patients with chronic severe hepatitis recurred. There were 11 cases of recurrence of chronic severe hepatitis and 4 cases of decompensated cirrhosis in 7 cases of compensatory cirrhosis. The indexes of alt AST and prothrombin time (PT) in patients with chronic severe hepatitis and chronic severe hepatitis were significantly higher than those in other groups (P0.05). Conclusion the nucleosides in elderly patients with chronic hepatitis B with negative e antigen usually recur within 6 ~ 12 months after withdrawal, and the liver damage is more serious after recurrence. The medical staff should guide the medication according to the actual condition of the patient to obtain the stable effect.
【作者單位】： 臨安市人民醫(yī)院感染科結(jié)核病門診;浙江大學(xué)附屬第一醫(yī)院傳染病科;
【分類號】：R512.62

【共引文獻】

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本文編號：2119404