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目的:探讨HBV-DNA早期快速下降对聚乙二醇干扰素α-2a联合恩替卡韦治疗拉米夫定耐药慢性乙型肝炎的疗效预测效果。方法:收集65例HBeAg阳性的对拉米夫定耐药的慢性乙型肝炎患者,回顾性分析其临床资料。结果:按照不同的HBV-DNA水平(小于3、3~5、大于5logcopies/ml)进行划分,对不同时间患者的HBeAg血清学转换情况进行分析可以发现,如果患者出现病毒学应答,则治疗24周HBeAg血清学转换率为28.13%,治疗48周HBeAg血清学转换率为40.63%,经比较差异有统计学意义,(P<0.05)。结论:对拉米夫定耐药慢性乙型肝炎患者实施聚乙二醇干扰素α-2a联合恩替卡韦治疗的过程中,通过对HBV-DNA下降情况的检测可以实现对治疗效果的良好预测,可作为临床检测指标之一。
Objective: To investigate the effect of early rapid decline of HBV-DNA on the efficacy of peginterferon alfa-2a combined with entecavir in the treatment of lamivudine-resistant chronic hepatitis B patients. Methods: Sixty-five HBeAg-positive patients with lamivudine-resistant chronic hepatitis B were collected and their clinical data were retrospectively analyzed. RESULTS: An analysis of HBeAg seroconversion in patients at various times at different HBV-DNA levels (less than 3, 3 to 5, greater than 5 logcopies / ml) revealed that if the patient developed virological response, treatment 24 The HBeAg seroconversion rate was 28.13%, and the HBeAg seroconversion rate was 40.63% after 48 weeks of treatment. The difference was statistically significant (P <0.05). Conclusions: In the course of treatment with lamivudine-resistant chronic hepatitis B patients treated with peginterferon alfa-2a combined with entecavir, a good prediction of the therapeutic effect can be achieved by detecting the decrease of HBV-DNA, As one of the clinical test indicators.