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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。
Objective To analyze the causes of antiviral therapy in patients with chronic HBV infection and to explore countermeasures. Methods Chronic hepatitis B virus infected patients were voluntarily registered in the clinic and followed up for a long time. The subjective and objective causes of antiretroviral therapy in the subjects were statistically analyzed. Results A total of 424 patients (300 males and 124 females) without antiviral therapy were enrolled in 951 patients (749 males and 202 females), of whom 319 (75.2%) did not meet the indications of antiviral therapy and were consistent with There were 105 cases (24.8%) of antiviral therapy indications, there were indications without antiviral therapy for the following reasons: fear of reproductive effects in 49 cases (46.7%), 31 cases of economic difficulties (29.5%), adverse reactions or There were 19 cases (18.1%) with uncertain course of treatment and 6 cases (5.7%) with poor compliance. The proportion of women without anti-virus treatment was higher than that of men (61.4% vs 40.0%, P <0.001) by sex. Conclusions The indications of antiviral therapy that did not meet the requirements of antiviral therapy are the main reasons that patients did not undergo antiviral therapy. The main reasons that meet the indications of treatment without antiviral therapy are, in turn, procreation, economic difficulties, uncertainties in the course of safety and efficacy Worries, poor compliance. Intervention Strategies: Long-term standardized follow-up and patient-patient doubts are effective ways to increase the proportion of patients receiving ART.