【摘要】 目的　观察拉米夫定治疗慢性乙型肝炎患者YMDD变异前、后血清乙肝标志物的变化情况。方法　检测37例拉米夫定YMDD变异患者治疗前、变异后以及 2 0例YMDD变异患者继续治疗 6个月时血清HBV DNA、HBeAg、前S1蛋白、ALT等指标的水平。结果　YMDD变异组治疗后的HBV DNA、ALT含量及前S1蛋白阳性率明显低于治疗前自身对照组 ,而HBeAg阳性率则无显著变化 ;YMDD变异组患者继续治疗 6个月时与刚变异时比较HBV DNA含量显著降低 ,而前S1蛋白、ALT含量则无显著性差异。结论　乙肝病毒的YMDD变异的患者拉米夫定治疗前、变异后血清乙肝标志物HBV DNA、前S1蛋白、ALT等水平变化显著 ;尽管发生了HBV聚合酶变异 ,这些病人在拉米夫定作用下仍显现持续HBV DNA抑制更多还原

【Abstract】 Objective To investigate the YMDD mutation and the levels of HBV DNA, HBeAg, pre S1 protein, and ALT in chronic hepatitis B patients with lamivudine therapy. Methods 37 patients with YMDD mutation were determined serum HBV DNA, HBeAg, pre S1 protein, and ALT levels and compared with themselves before mutation. After six months lamivudine treatment, 20 patients with YMDD mutaion were studied. Results After lamivudine therapy, patients with YMDD mutation showed significantly decrease than themselves before lamivudine treatment in the levels of HBV DNA, pre S1 protein, and ALT. After six months lamivudine treatment the group with YMDD mutation showed significantly decrease in the level of HBV DNA, but pre S1 protein and ALT levels were not significantly changed. Conclusion Patients with YMDD mutation showed significantly decrease in the levels of HBV DNA, pre S1 protein, and ALT than themselves before lamivudine treatment. Although YMDD mutation occurred, HBV DNA replication still could be suppressed after prolong lamivudine treatment.更多还原