【摘要】 目的:观察富马酸替诺福韦二吡呋酯(TDF)治疗慢性乙型肝炎(CHB)的短期疗效。方法:回顾性分析20例CHB患者病历资料,均给予TDF 300 mg/d口服治疗。检测TDF治疗前后乙肝病毒耐药突变、血清ALT、HBeAg定量、HBVDNA定量,以及肾功能、血常规和甲胎蛋白等指标。结果:治疗第8周时HBVDNA不可测比率,ALT<2倍正常值上限(ULN)患者较ALT≥2倍ULN的患者高(P=0.022),HBeAg阴性患者比HBeAg阳性患者高(P=0.004),拉米夫定(LAM)非耐药患者比LAM耐药的患者高(P=0.029),治疗第24周时,上述病毒学应答率的差异均消失,所有患者达到HBVDNA不可测的比率为85.0%,ALT正常率为100%,HBeAg阳性患者均未出现HBe血清学转换。患者治疗初始与治疗24周时相比,甲胎蛋白、血尿素氮、血肌酐水平及白细胞、血小板计数的水平无差异(P>0.05)。结论:替诺福韦酯治疗CHB应答迅速,治疗24周HBVDNA检测不到的比率高(85.0%),达到HBe血清学转换比率低(0%),未出现明显副作用。更多还原

【Abstract】 Objective:To observe the short-term therapeutic effect of Tenofovir Disoproxil Fumarate( TDF)in treatment of chronic hepatitis B( CHB).Methods:Clinical data of 20 cases with CHB were analyzed retrospectively,and they were given TDF 300 mg/d orally.Patients’ drug resistance mutation,serum ALT,HBeAg quantify and HBVDNA level,as well as renal function,blood routine examination and alpha-fetoprotein protein( AFP)were determined before and after TDF treatment.Results:After 8 weeks of treatment,the HBVDNA undetectable ratio was higher in patients with ALT <twice upper limit of normal( ULN)group than that of patients in ALT≥2ULN group( P =0.022),and HBeAg negative group was higher than that of HBeAg positive group( P = 0.004),and patients without lamivudine( LAM)drug resistance group was higher than that of patient with LAM drug resistance group( P = 0.029).At 24th weeks,the differences of the patients’ virological response rates disappeared between the groups mentioned above,and the HBVDNA undetectable rate was 85.0% and normal ALT rate was 100% in all patients.But HBeAg positive patients did not appear HBe seroconversion.Compared with that in initial period,the patients’ AFP,blood urea nitrogen,serum creatinine,white blood cells and platelet count levels showed no differences( P > 0.05).Conclusion:TDF in treatment of CHB can achieve a rapidly response.Patients present a high HBVDNA undetectable rate( 85.0%),but a low HBe seroconversion rate( 0%)after 24weeks’ treatment,and without no obvious side effects.更多还原