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目的:探讨HBeAg阳性和阴性慢性乙肝患者经拉米夫定治疗后HBVYMDD变异、HBV DNA消失率、ALT复常率情况。方法:将病例分成两组,HBeAg阳性48例,HBeA阴性48例,均口服拉米夫定100mg/d。治疗前和治疗9个月、12个月、18个月、24个月分别检测血清标本HBVYMDD变异、HBV DNA消失率、ALT复常率。结果:治疗前和治疗9个月两组HBVYMDD变异率无差别(P>0.05);治疗12个月、18个月、24个月两组HBVYMDD变异率均有显著性差异(P<0.05)。治疗前和治疗9个月、12个月、18个月、24个月两组HBV DNA消失率、ALT复常率均无显著性差异(P>0.05)。结论:HBeAg阳性乙肝患者经拉米夫定治疗后较HBeAg阴性患者易发生HBVYMDD变异,但治疗效果无明显差异。
Objective: To investigate the changes of HBV YMDD, the disappearance of HBV DNA and the normalization rate of ALT in patients with HBeAg-positive and -negative chronic hepatitis B after lamivudine treatment. Methods: The patients were divided into two groups, 48 cases were positive for HBeAg and 48 cases were negative for HBeA. All patients were given oral lamivudine 100 mg / d. Pretreatment and treatment of 9 months, 12 months, 18 months, 24 months were detected serum HBVYMDD mutation, HBV DNA disappearance, ALT normalization rate. Results: There was no significant difference in HBVYMDD mutation rate between the two groups before treatment and at 9 months (P> 0.05). The mutation rates of HBVYMDD in 12 months, 18 months and 24 months were significantly different (P <0.05). Before treatment and 9 months, 12 months, 18 months and 24 months, there was no significant difference in the disappearance rate of HBV DNA and ALT normalization rate between two groups (P> 0.05). Conclusion: HBeAg-positive hepatitis B patients are more susceptible to HBV YMDD mutation than HBeAg-negative patients after lamivudine treatment, but the treatment effect is not significantly different.