【摘要】 目的对慢性HBV感染者未进行抗病毒治疗的原因进行分析并探讨对策。方法对感染科门诊就医的慢性HBV感染者,自愿在门诊登记并长期随访,统计分析观察对象中未抗病毒治疗的主客观原因。结果 951例(男749例,女202例)患者中未行抗病毒治疗者共424例(男300例,女124例),其中未符合抗病毒治疗指征者319例(75.2%),符合抗病毒治疗指征者105例(24.8%),有指征而未抗病毒治疗的原因分别为:担心对生育影响49例(46.7%),经济困难31例(29.5%),顾虑不良反应或不确定疗程19例(18.1%),依从性差6例(5.7%);按性别比较,女性未抗病毒治疗的比例高于男性(61.4%vs 40.0%,P<0.001)。结论未符合抗病毒治疗指征是患者未进行抗病毒治疗的主要原因,而符合治疗指征而未进行抗病毒治疗的主要原因依次为生育困扰、经济困难、对安全性与疗效疗程不确定性的担忧、依从性差。干预策略:长期规范的随访和消除患者的疑虑是提高患者接受抗病毒治疗比例的有效措施。更多还原

【Abstract】 Objective To investigate the reasons of the patients with chronic hepatitis B virus(HBV) infection without antiviral therapy and to explore its therapeutic strategies. Methods Long-termed observation on the out-patients with chronic HBV infection,who were voluntarily to be followed-up in clinic,was recruited for analysis of the objective and subjective causes of absence of antiviral therapy. Results Antiviral therapy was absent in 424 patients(300 male,124 female) among total 951 patients(749 male,202 female).Meanwhile,105 patients(24.8%) was,while the other 319 patients(75.2%) was not,indicated for antiviral therapy.The reasons of those who had indications but did not receive antiviral therapy were as followed: worry about potential adverse effect on fertility(49 patients,46.7%),unaffordability(31patients,29.5%),side-effect of drugs or uncertainty of treatment duration(19/105,18.1%),and poor compliance(6/105,5.7%).The proportion of females not receiving antiviral therapy was significant higher than that of males(61.4% vs 40.0%,P<0.001). Conclusion The lack of antiviral indication is the main reason in untreated group.The reasons of those with indications but receive no antiviral therapy are followed by worry about harmful effect on fertility,unaffordability,side-effect of drugs or uncertainty of treatment duration,and poor compliance.Regular long-term follow-up and elimination of treatment anxiety would increase the proportion of patients with chronic HBV receiveing anti-HBV therapy.更多还原