慢性乙型肝炎患者停用核苷(酸)类药物后临床特征分析

摘要

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.%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.