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目的介绍日本对慢性乙型肝炎和肝硬化的最新治疗及研究进展的现状。方法以2011年日本慢性乙型肝炎肝硬化的治疗指南为基础,结合近年来日本的代表性文献,进行归纳分析。结果与结论阐明乙肝病毒量的高低与本病进展的预后密切相关;明确乙型肝炎的治疗主要参考乙型肝炎病毒脱氧核糖核酸(hepatitis B virus DNA,HBV DNA)定量、基因型和年龄,分别使用核苷类药或干扰素;通过抑制乙肝病毒的复制,可以控制疾病的进展,减少肝硬化和肝癌的发生。同时,报告了核苷制剂的有效性,介绍使用核苷制剂的具体步骤和发生耐药性时的处理方法;提出合并肝硬化的治疗方案以及对免疫抑制剂和化学抗癌疗法给药后引发乙型肝炎时的对策;强调无症状B型肝炎病毒感染者并非临床痊愈,亦需要定期检测和对症处理。
Objective To introduce the latest treatment and progress of chronic hepatitis B and cirrhosis in Japan. Methods Based on the guidelines for the treatment of chronic hepatitis B cirrhosis in Japan in 2011 and the representative documents from Japan in recent years, the inductive analysis was conducted. Results and Conclusions The level of hepatitis B virus is closely related to the prognosis of this disease. It is clear that the treatment of hepatitis B is mainly based on the quantitative, genotype and age of hepatitis B virus DNA (HBV DNA) The use of nucleoside drugs or interferon; by inhibiting the replication of hepatitis B virus, can control the progress of the disease, reduce the occurrence of cirrhosis and liver cancer. At the same time, reported the availability of nucleoside formulations, describes the specific steps of using the nucleoside formulations and treatment methods in the event of resistance; proposed treatment of cirrhosis combined with immunosuppressive agents and chemical anti-cancer therapy after the trigger Hepatitis B countermeasures; stressed that asymptomatic hepatitis B virus infection is not clinically cured, also need regular testing and symptomatic treatment.