Saturday, 15 September 2007
Does second liver stop drug what does common error have?
Answer chronic hepatitis B, need undertakes disease-resistant poison. But, content of use disease-resistant bane needs to hold to how long, can be the illness brought about to relapse after stopping drug? Hospital of accessary Mount Hua Professor Zhang Jiming points out Fudan University, about the period of treatment of disease-resistant poison and the opportune moment that pause medicine, the patient still has a few errors on understanding, narrate 3 kinds below especially most common. One: Disease-resistant poison need is lifelong with medical many second liver wardmate think, second liver and hypertension, diabetic same, need is lifelong take drug. This kind of wrong idea is very influential force. Make therapeutics of many patient antagonism virus indecisive, delayed an opportunity accordingly. Professor Zhang Jiming points out, disease-resistant poison cure is not need lifelong with medicine. Newest " Asia-Pacific liver disease learned chronic hepatitis B to run a guide 2008 " (the following abbreviation " Asia-Pacific guideline " ) make clear, after the patient treats E antigen positive, if came true " double amount to mark " , namely the HBV-DNA in blood does not detect, at the same time E antigen produces serological changeover (E antigen disappears, E antibody produces) , after this every half an year checks, amount to mark twice continuously, can consider to stop drug so. In recent years a few clinical data also make clear, if replace,have thing of bane of a few disease-resistant really wait surely than the husband restraining HBV-DNA and respect of changeover of stimulative E antigen to conduce to a patient coming true " double amount to mark " . 2: Stop medicine to jump over a lot of good patients earlier to determination and second liver virus hit " protracted battle " . But should hold to after all to this battle how long, devoid recognition. Some patients are fighting a few months after virus is treated, virus index improves apparently, hope get better closes, stop drug some earlier. Still some patients use drug a few months, virus index was not achieved anticipate turn the target of shade, think to do not have action and stop treatment instantly. To this, professor Zhang Jiming points out, cure of virus of the liver that fight second must have patience and hope. The premise that stops drug is to must complete enough period of treatment, achieve booked remedial goal. According to our country 2005 " guideline of prevention and cure of chronic second liver " requirement, patient of E antigen positive fights virus cure to must hold to above 2 years, and " Asia-Pacific guideline " ask, implementation " double amount to mark " hind treat 1 year at least, check regularly. As to the patient of E antigen negative, according to the proposal of most guideline on the guideline of our country and international, primary period of treatment should hold to two years half. 3: Standard stopping drug is machine-made different patient because illness each different, remedial progress can differ somewhat, time stopping drug also cannot one knife is cut. Clinical data shows, level of 2 times above, HBV-DNA is less than transaminase 9 times of 10 square patient achieves level stopping drug more easily, this kind of patient medications through accepting disease-resistant poison, e antigen happens when 2 years the opportunity of serological changeover can be amounted to 47% , come true then stop drug. And the patient that adds up to afore-mentioned conditions to notting agree with, the specialized subject doctor that has experience can be passed " route chart " will adjust remedial plan in time, in order to improve remedial result. With nucleotide kind medicaments is exemple, the patient uses drug 6 months, if the HBV-DNA in every milliliter blood cannot fall,arrive under 10000 copies, strengthen with respect to need along with visit, can adjust remedial plan when necessary. This shows, choose the proper remedy, plan that chooses science, and hold to after all, the way that can allow liver of beat back second goes evener more. (the exercitation edits: Plum apricot)
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