Bước đầu đánh giá hiệu quả điều trị Entecavir trên bệnh nhân viêm gan virus B mạn tính HBeAg dương tính và HBeAg âm tính

TCNCYH 66 (1) - 2010

weeks. Results: lhi>re was no cdlleclidn of inflammatory cells at the lime of evaluation. At 4 weeks, lhe

vasc:ulari/'ation and the invasion of fibroblasts were noted and at 8 weeks some new woven bone ardund

Ihe graft were fdiind. Conclusion: there was no evidence of infection and rejection, fhe alldgraft lenddii lo

bone healing was recogni/cd with the same manner of autdgraft. . ;, . ,,

Keywords: allograft, experimental, tendon graft, tendon to bone healing i i; > i

Ba6c DAU DANH GIA HIEU QUA DIEU TRj ENTECAVIR TREN

BENH NHAN VIEM GAN VIRUS B MAN TINH HBeAg DUON G TINH

VA HBeAgAMTINH . ,

Nguyen Cong Long, Dao Van Long, Biii Xuan Trfldng, Le Van Anh

Khoa Tieu hda - Benh vicn Bach Mai I la Ndi

Muc tieu: dinh gii tie dung, tinh an toin ciia Entecavir trong dieu trj vlSm gan virus B man tinh cd

HlieAg(+) va HBeAg(-). Doi tUgng va phuang phap nghien cdu: nghien cifu tie'n cdu 47 benh nhim dtfdc

chan doan viem gan virus B man linh (VGVRB) ehia hai nhdm ilBeAg(+) vi HBeAg(-) dtfgc dieu trj Hntecavir

i>,') mg/ngay trang thdi gian 12 tuan. Kit qua: dac diem tudi nhdm ilBeAg(-) caa han nhdm HBeAg(+), tdn

thuang md henh hgc nhdm HBeAg(-) nang ban nhdm HBeAg(+) vdi chi so viem 10,1 ± 2,8 so vdi 9,6 ± 2,2,

chl sd xa 2,78 ± 1,8 so vdi 1,8 ± 1,3 diem mac dii nong do HBV DNA d nhdm HBeAg(+) eao ban nhdm

IIBeAg(~) 8,29 ± 0,87 sa vdi 6,23 ± 1,62 lagcaples/ntl. Nong do HBV DNA giam > 2 logcopies/ml sau 12

luan dieu trj hntecavir 0,5mg/ngay la 95,7%, vdi nhdm HBeAg(-i-) la 94,1% va nhdm HBeAg(-) li 96,7%.

Ndng do HBV DNA dat difdi ngifdng phit hien dat J6,2%, frung binh nong do HBV DNA giam 4,71 ± 1,8

logcoples/ml d nhdm VCVRB HBeAg(+) vi - 4,84 ± 1,7 logcaples/ml d nhdm VGVRB HBeAg(-). Ty le

chuyen dao huyet thanh d nhdm HBeAg(+) la 17,t)°/o, binh thifdng hai men gan ALT li 51,l"7o. Cic tneu

chdng lam sing met mdi, chin an eai thien d 1U0%> benh nhan, lic dung phu ciia thudc it gap, thudng nhe,

hay gap nha't la dau dau va viem mui hgng. Kit luan: lnlecavir li thud'c cd kha niing ifc che sU nhan len ciia

virus tdt d ca hai nhdm viem gan virus B man tinh cd HBeAg(+) vi HBeAgi-l, hinh thudng bail men gan va

ehuyen dao huyet lhanh l-IBeAg dat ly le kha cao, cai thien tneu chdng lam sang tdt. It lac dung phu, nen

hfa chgn la thudc dau tay trong dieu trj viem gan virus R man tinh.

Tii khoa: viem gan virus B, entecavir

I. DA T VA N D E dflpc xdp vao vung dai djch nhiein LIBV vdi

Hien nay thc'^ gidi cd tren 350 trieu ngfldi phfldng thflc lay truyin chu ye'u tfl me sang con,

nhiem HBV man tinh |9|, so' benh nhan nhii m ddng thdi LIBV la nguyen nhan chinh gay vii^m

LIBV man tinh cd HBsAg dflong tinh tai Trung gan man, xo gan va ung thfl gan. lOieu trj viem

Qucdc va khu vflc t3dng Nam chau A trong dd cd gan virus B cd nhiiu tien bp trong thap ky qua.,

Vii^t nam chiem khoang 50% tdng sd benh nhi n Interferon - alpha dflpc xem la thud'c dau lien

tri§n tdan \hi gidi. Tai Viet Nam, ty le nhii m difpc cdng nhan trong dieu trj, nhifng thudc

HBV cd HBsAg difong tfnh cao tren 8% di n sd nhdm cytokine nay chl cd hicMi qua khoing 35%