摘要
目的探讨核苷（酸）类药物治疗慢性乙型肝炎（CHB）患者达停药标准后不同巩固治疗期的停药复发率差异。方法回顾性分析接受核苷（酸）类药物（NAs）治疗达到停药标准后停药的102例CHB患者资料，停药后按巩固治疗期长短分组比较不同组的停药复发率。采用乘积限法（Kaplan—Meiermethod）计算累计复发率，采用时序检验（Logranktest）进行累计复发率的比较。结果患者停药后第6、12、18、24、36、48月的累计复发率，达标组分别为52．3％、70．O％、74．3％、76．7％、82．4％、88．4％，达标后延长疗程组分别为24．0％、38．8％、40．6％、43．3％、43．3％、43．3％。结果表明达标后延长疗程组的累计复发率明显低于达标组。患者停药后第6、12、18、24、36、48月的累计复发率，达标＋12月组分别为35．0％、48．2％、51．9％、57．9％、57．9％、57．9％，达标＋24月组分别为18．1％、30．7％、30．7％、30．7％、30．7％，达标＋36月组分别为7．1％、21．4％、21．4％、21．4％。结果表明达标＋12月组累计复发率最高，达标＋24月组次之，达标＋36月组最低。达标组、达标＋12月组、达标＋24月组、达标＋36月组四组患者停药后随访期间复发总例数分别为26例、21例、5例、3例。结论接受NAs抗病毒治疗的CHB患者，达2010年指南停药标准后应适当延长巩固治疗期，以减少停药后复发。
Objective To retrospectively investigate the relapse rates of different duration of extended consolidation after withdrawal of nucleos（t） ide analogues （NAs） treatment in patients with chronic hepatitis B （CHB） who met NAs cessation criteria. Methods 102 CHB patients discontinued treatment according to NAs cessation criteria or extended duration of consolidation therapy after meeting the cessation criteria. 30 patients meeting the cessation criteria were Group A. 72 patients extending consolidation therapy after meeting the cessation criteria were Group B. Based on different duration of extended consolidation therapy, 72 patients were divided into 3 groups. Patients with a duration of extended 12 months after meeting NAs cessation criteria were Group B1. Patients with a duration of extended 24 months were Group B2. Patients with duration of extended 36 months were Group B3. After cessation of NAs treatment, the cumulative relapse of different group was calculated by the Kaplan-Meier method. The cumulative relapses between the selected groups were analyzed with Log-rank test. Results The cumulative relapse rates after 6,12,18,24,36 and 48 months after cessation of NAs treatment were 52. 3 % , 70. 0% , 74.3 % , 76.7 % , 82.4% and 88.4% in Group A; 24.0%, 38.8%, 40.6%, 43.3%, 43.3% and 43.3% in Group B; respectively. The relapse rate of Group B was much lower than that of Group A. The cumulative relapse rates after 6,12, 18,24,36 and 48 months after cessation of NAs treatment were 35.0% , 48.2% , 51.9% , 57.9%, 57.9% and 57.9% in Group B1; 18.1%, 30.7%, 30.7%, 30.7%, 30.7% in Group B2; 7. 1% , 21.4% , 21.4% , 21.4% in group B3; respectively. The relapse rate of Group B1 was the highest, the following was of Group B2, and of Group B3 was the lowest one. The total amount of relapse in Group A, B1, B2 and B3 was 26, 21, 5 and 3 respectively. Conclusions A longer duration of extended consolidation therapy after meeting NAs cessation criteria may contribute to the lower relapse rates.
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
2016年第5期486-489,共4页
Chinese Journal of Experimental and Clinical Virology
基金
国家自然科学基金（81500462）
广东省药学会基金（2012GRS01,2013GRS06）
关键词
肝炎
乙型
慢性
核苷酸类
治疗结果
停药
复发
Hepatitis B, chronic
Nucleosides
Treatment outcome
Adefovirdipivoxil
HBeAg-positive
