论文部分内容阅读
目的研究拉米夫定治疗慢性乙型肝炎后乙肝病毒YMDD变异及Pre-S1抗原的变化。方法选择未发生YMDD变异的慢性乙型肝炎患者190例,予拉米夫定治疗6个月后检测其YMDD变异、Pre-S1抗原、AST、ALT及HBV-DNA,并分析Pre-S1抗原阳性。结果 190例慢性乙型肝炎患者经过拉米夫定治疗后发生HBV-YMDD变异率为35.3%。其中YMDD变异组Pre-S1抗原阳性率为67.16%(45/67),与YMDD非变异组(69.92%,86/123)比较差异无统计学意义。Pre-S1抗原阳性患者AST、ALT、HBV-DNA含量均明显高于Pre-S1抗原阴性者。结论 1慢性乙型肝炎患者应用拉米夫定抗病毒治疗可能发生YMDD变异。2YMDD变异的发生与Pre-S1抗原是否转阴无关,但Pre-S1抗原阳性的慢性乙型肝炎患者肝功能更容易受损。
Objective To study the variation of hepatitis B virus YMDD and Pre-S1 antigen in patients with chronic hepatitis B after lamivudine treatment. Methods 190 patients with chronic hepatitis B without YMDD mutation were selected. YMDD mutation, Pre-S1 antigen, AST, ALT and HBV-DNA were detected after 6 months of treatment with lamivudine. Pre-S1 antigen was analyzed . Results The mutation rate of HBV-YMDD in 190 patients with chronic hepatitis B after lamivudine treatment was 35.3%. The positive rate of Pre-S1 antigen in YMDD mutation group was 67.16% (45/67), which was not significantly different from that in YMDD non-mutation group (69.92%, 86/123). Pre-S1 antigen-positive patients with AST, ALT, HBV-DNA content were significantly higher than Pre-S1 antigen-negative. Conclusion 1 YMDD mutation may occur in patients with chronic hepatitis B treated with lamivudine antiviral therapy. The occurrence of 2YMDD mutation has nothing to do with whether Pre-S1 antigen is negative, but liver function in patients with Pre-S1 antigen-positive chronic hepatitis B is more likely to be impaired.