文章摘要
胡晓凤 陈建杰 朱敏芳 明利平.VSD负压引流技术结合游离植皮治疗大面积皮肤缺损的 临床疗效研究[J].,2014,14(16):3134-3137
VSD负压引流技术结合游离植皮治疗大面积皮肤缺损的 临床疗效研究
Significance of Quantitative Testing Hepatitis B virus (HBV) to AvoidNucleoside Analogues (NAs) Abusing
  
DOI:
中文关键词: 乙肝病毒  实时定量PCR  拉米夫定  核苷类似物
英文关键词: HBV  TaqMan RT-PCR  Lamivudine (LAM)  Nucleoside analogues
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作者单位
胡晓凤 陈建杰 朱敏芳 明利平 上海浦东新区传染病医院检验科 
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中文摘要:
      目的:探讨核苷类似物(NAs)拉米夫定(LAM)用药时间与乙型肝炎(CHB)患者体内HBV病毒血清HBV-DNA 载量的关 系。方法:选取214 例HBeAg 阳性患者,在LAM(100 mg/d)的36 个月用药治疗前使用实时荧光定量PCR 进行血清HBV-DNA 载量进行测定,并使用特异性引物鉴定HBV病毒DNA保守位点YMDD的抗药性突变以及病毒株的变化情况。结果:(1)214 例 患者均对LAM产生应答,在治疗12-18 个月后血清HBV-DNA载量稳定在较低水平。(2)病毒株在NAs 治疗前已经出现耐药性 突变(18 %),用药加速了HBV 病毒的耐药进化,18 个月后耐药病毒数在214 例样本中均超过10%的检测标准。结论:LAM治疗 在9-18 个月获得良好的治疗效果,建议24 个月后停药更换临床处方防止耐药病毒株的进化。
英文摘要:
      Objective: To study the relationship between intra-hepatic HBV-DNA level and the durance of applying LAM in patients with chronic hepatitis B (CHB), and assess the valuation of lamivudine (LAM) in anti-virus therapy.Methods:Two-hundred and fourteen HBeAg positive patients were treated with the LAM (100 mg/d) for 36 months. At the same time, serum HBV-DNA load was detected by real time fluorescence quantitative PCR before every stage of treatment, and the specific primers were used to identify the HBV virus DNA conservative site YMDD resistance mutations and the changes in the virus strains.Results:(1) All of the 214 patients were responded to LAM treatment, and the serum HBV-DNA load maintains at low levels after12-18 months treatment. (2) Drug-resistance mutation strains were found in about 18 % of samples before NAs treatment, LAM accelerated the drug resistance evolution in HBV virus.After18 months, the anti-drug virus was identified in all of 214 samples.Conclusion:LAMtreatment has a good therapeutic effect in 9-18 months. However, inhibitory effect on virus decreased gradually after more than 24 months because of the resistant strain accumulation,, such as serological indicators meeting the stopping criteria, and we suggest replacing the clinical prescription to prevent the evolution of drug resistant strains.
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