Nakamuta Makoto, Morizono Shusuke, Tanabe Yuichi, Kajiwara Eiji, Shimono Junya, Masumoto Akihide, Maruyama Toshihiro, Furusyo Norihiro, Nomura Hideyuki, Sakai Hironori, Takahashi Kazuhiro, Azuma Koichi, Shimoda Shinji, Kotoh Kazuhiro, Enjoji Munechika, Hayashi Jun
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-5282, Japan.
World J Gastroenterol. 2005 Nov 28;11(44):6948-53. doi: 10.3748/wjg.v11.i44.6948.
To further evaluate the relationship between BSA and the effects of lamivudine in a greater number of cases and over a longer period of observation than in our previous evaluation.
We evaluated 249 patients with chronic hepatitis B. The effects of treatment for one year (n = 249), two years (n = 147), and three years (n = 72) were evaluated from the levels of serum ALT and HBV-DNA, as biological and virological effects (undetectable levels by PCR), respectively. Moreover, several variables that could influence the response to treatment, including ALT, albumin, bilirubin, platelet counts, BSA, HBV-DNA, and HBeAg were analyzed.
For 1-year treatment, multivariate analysis revealed that BSA (P = 0.0002) was the only factor for the biological effect, and that ALT (P = 0.0017), HBV-DNA (P = 0.0004), and HBeAg (P = 0.0021) were independent factors for the virological effect. For 2-year treatment, multivariate analysis again showed that BSA (P = 0.0147) was the only factor for the biological effect, and that ALT (P = 0.0192) and HBeAg (P = 0.0428) were independent factors for the virological effect. For 3-year treatment, multivariate analysis, however, could not reveal BSA (P = 0.0730) as a factor for the normalization of ALT levels.
BSA is a significant predictor for the normalizing the effect of lamivudine therapy on ALT for an initial 2-year period, suggesting that lamivudine dosage should be based on the individual BSA.
与我们之前的评估相比，在更多病例和更长观察期内进一步评估体表面积（BSA）与拉米夫定疗效之间的关系。
我们评估了249例慢性乙型肝炎患者。分别从血清丙氨酸氨基转移酶（ALT）水平和乙肝病毒脱氧核糖核酸（HBV-DNA）水平评估一年（n = 249）、两年（n = 147）和三年（n = 72）治疗的效果，将其作为生物学和病毒学效应（PCR检测不到的水平）。此外，分析了几个可能影响治疗反应的变量，包括ALT、白蛋白、胆红素、血小板计数、BSA、HBV-DNA和乙肝e抗原（HBeAg）。
对于1年治疗，多变量分析显示BSA（P = 0.0002）是生物学效应的唯一因素，而ALT（P = 0.0017）、HBV-DNA（P = 0.0004）和HBeAg（P = 0.0021）是病毒学效应的独立因素。对于2年治疗，多变量分析再次表明BSA（P = 0.0147）是生物学效应的唯一因素，而ALT（P = 0.0192）和HBeAg（P = 0.0428）是病毒学效应的独立因素。然而，对于3年治疗，多变量分析未显示BSA（P = 0.0730）是ALT水平正常化的因素。
BSA是拉米夫定治疗最初2年ALT水平正常化效果的重要预测指标，提示拉米夫定剂量应基于个体BSA。
