【摘要】 目的:研究拉米夫定治疗慢性乙型病毒性肝炎（CHB）的疗效及影响因素。方法:选择96例CHB患者,口服拉米夫定100mg,qd。全程监测患者血清ALT,AST,BIL,HBV M,HBV DNA,HBV YMDD变异和HBV基因型。结果:拉米夫定治疗18个月总有效率为71．9％,eAg转阴与血清转换分别为16．7％和14．6％,HBV DNA转阴占53．1％,有39．6％下降10²拷贝·mL^-1,但是至18个月HBV YMDD发生变异者达31．3％;HBV B基因型和C基因型的总有效率分别为84．7％,32．3％。治疗过程中未发现明显不良反应。结论:拉米夫定治疗CHB有效,但容易导致HBV YMDD区域突变。HBV B基因型的疗效优于C基因型。更多还原

【Abstract】 Objective:To evaluate the efficacy of lamivudine for patients with chronic hepatitis B （CHB）.Methods:96 patients with CHB were orally taken with lamivudine 100mg once per day for 18 months.The serum samples were collected to measure concentrations of ALT,AST and BIL as well as the HBV mark,HBV DNA load,HBV YMDD motif mutations and the HBV genotype.Results:At the end of the 18-month therapy,the lamvudine-treated patients with CHB showed an overall efficacy rate of 71.9%,eAg negative of 16.7%,eAb of 14.6% and HBV DNA load negative of 53.1%.36.9% of pa- tients reduced the HBV DNA load by 10²copy·mL^-1.The YMDD motif mutations rate was 31.3% at the end of the 18-month therapy.The overall efficacy rate for the CHB patients with genotype B and C was 84.7% and 32.3%,respectively.No adverse events were reported during the study.Conclusion: Lamivudine provided a superior therapy of HBV genotype B over genotype C.更多还原