慢性乙型肝炎患者停用核苷(酸)类药物后临床特征分析
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国家科技重大专项(2013ZXl0002005);江苏省卫生厅医学创新团队与领军人才培养基金(LJ201121);中国肝炎基金会天晴肝病研究基金(CFHPC20132071)


Clinical features of chronic hepatitis B patients after stopping nucleos(t)ide analogues
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    摘要:

    目的:探讨慢性乙型肝炎患者停用核苷(酸)类药物后的临床特征及影响因素。方法:收集73例慢性乙型肝炎患者停药后的临床资料,分析影响核苷(酸)类药物停药复发时间的因素。结果:拉米夫定组与联合用药组复发时间比较,患者复发时间较长(P=0.031)。在抗病毒疗程>24个月组,恩替卡韦与联合用药组复发时间比较,患者复发时间较长(P=0.048);拉米夫定组与恩替卡韦组复发时HBV DNA水平比较,恩替卡韦组患者HBV DNA水平较低(P=0.039)。在未达标患者中,抗病毒疗程是影响核苷(酸)类药物停药复发时间的危险因素。结论:大多数患者未达到停药标准而自行停药,已达到停药标准患者,停药后仍有较高复发率。在未达标患者中,抗病毒疗程长,与短时间内复发有关。

    Abstract:

    Objective:To investigate the clinical features of chronic hepatitis B patients after stopping nucleos(t)ide analogues and related factors for hepatitis B relapse. Methods:We investigated 73 chronic hepatitis B patients who withdrew nucleos(t)ide analogues and analyzed the reasons for withdrawal and related factors for hepatitis B relapse. Results:Those who stopped lamivudine had longer relapse time compared with combination therapy(P=0.031). Among patients with total treatment duration more than 24 months,those who stopped entecavir had longer relapse time compared with combination therapy(P=0.048),and lower HBV DNA level while relapsed compared with lamivudine(P=0.039). The COX proportional hazards model analysis showed that total treatment duration was the risk factor for hepatitis B relapse after stopping nucleos(t)ide analogues with patients who did not achieve cessation criteria. Conclusion:Most patients stopped nucleos(t)ide analogues without achieving cessation criteria. There was a still high relapse rate among patients in spite of they had achieved cessation criteria. The longer antiviral treatment duration was associated with a short time recurrence with those who did not achieve cessation criteria.

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史 萍,蒋龙凤,韩亚萍,徐菱遥,刘 瑶,岳 明,李 军.慢性乙型肝炎患者停用核苷(酸)类药物后临床特征分析[J].南京医科大学学报(自然科学版),2018,(5):638-642

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  • 收稿日期:2017-12-13
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  • 在线发布日期: 2018-05-16
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