中文摘要：

目的研究分析影响拉米夫定治疗HBeAg阴性慢性乙型病毒性肝炎疗效的主要相关因素。方法收集2006年1月至2009年12月在我科和门诊就诊并接受拉米夫定治疗的HBeAg阴性慢性乙型肝炎203例患者临床资料,分析患者治疗前性别、年龄、血清ALT水平、HBV DNA水平、基因型等因素与疗效的相关性。结果获得病毒学应答患者为180例（88.7%）,应答患者较之无应答患者基线HBV DNA水平较低;长期治疗时发生病毒学突破患者为81例（45%）,发生病毒学突破患者较之获得持续应答的患者基线HBV DNA水平较高;COX比例风险回归模型分析认为,治疗前HBVDNA水平以及治疗6个月时HBV DNA状态是发生病毒学突破的危险因素。结论拉米夫定治疗HBeAg阴性慢性乙型病毒性肝炎过程中,治疗前较低的HBV DNA水平能够获得较好的应答,治疗6个月时HBV DNA阳性状态是病毒学突破的高危因素。

英文摘要：

Objective To study the factors related to lamivudine efficacy in treating hepatitis B e-antigen（HBeAg）-negative chronic hepatitis B.Methods The clinical data of 203 HBeAg-negative chronic hepatitis B patients who received lamivudine treatment in our hospital were collected from Jan.2006 to Dec.2009.The correlation of lamivudine efficacy with factors before therapy,such as gender,age,blood serum alanine transaminase（ALT） level,blood serum hepatitis B virus（HBV） DNA level,and HBV genotype,was analyzed.Results Among the 203 patients,180（88.7%） achieved virological response and exhibited a lower baseline HBV DNA level than those without virological response.During long-term therapy of the 180 cases,81（45%） experienced virological breakthrough and exhibited a higher baseline HBV DNA level than those with continuous virological response.Cox proportional-hazards regression model analysis results showed that HBV DNA level before therapy and HBV DNA positive in the 6th month of therapy were risk factors associated with virological breakthrough.Conclusion During lamivudine treatment of HBeAg-negative chronic hepatitis B,a lower HBV DNA level before therapy can result in better response.HBV DNA positive in the 6th month of therapy is a high risk factor associated with virological breakthrough.