air jordan high heels Clinical treatment of hepati

lin06900 · Wysłany: Pon 6:32, 28 Mar 2011

Clinical treatment of hepatitis B status and future

Arduous task. 2, the treatment of chronic hepatitis B patient several issues of common concern 2.1 How to choose the treatment of interferon or lamivudine, mainly from both efficacy and adverse effects were compared. According to the majority of the literature, is still to interferon treatment of chronic hepatitis B and chronic hepatitis C drug of choice. 2.2 Variation of lamivudine and HBV According to statistics, lamivudine (lamivudine) 7 months after treatment may have HBV mutation and drug longer, the higher the mutation rate. Species variation is a common phenomenon in nature, biological adaptation to the environment is an important way to survive on the genetic evolution of great significance. HBV can be known genes, 7 (A ~ G). Expression of HBV infection in chronic hepatitis B core mutation probability different, so there should be subjective judgments. 2.2.1 The mechanism of virus variation was mainly due to the short half-life of HBV, copy rate. Lack of correction reverse transcriptase, virus replication mismatch early,[link widoczny dla zalogowanych], and the result of selective pressure. 2.2.2 Variation of the clinical features of serum transaminase (AIT) rose again after the normalization, HBV-DNA/HBeAg negative became positive again or levels, clinical symptoms can be mild or even lacking. Determination can be determined by gene chip the presence of virus mutation and sites. Some applications, such as lamivudine treatment of patients with elevated aminotransferases occurred, should be to rule out the possibility of non-HBV variant, such as the progression of the disease, treatment of other diseases or irregular. 2.2.3HBV treatment variation (YMDD) HBV mutants after the event, there are different views on how to deal with: ① 72 clinicians should continue lamivudine therapy. The reason is that drugs can inhibit the replication of wild type HBV,[link widoczny dla zalogowanych], reduce or delay the occurrence of liver fibrosis. ② addition of other antiviral drugs, or a how Defu Wei Zhejiang 』a 2 1 =:: more interferon. ⑧ termination of lamivudine therapy. In addition to patients with decompensated liver function outside can be gradually discontinued,[link widoczny dla zalogowanych], but should pay close attention to changes in condition, and to the appropriate treatment. 2.2.4 Patients with chronic hepatitis B cirrhosis treatment in general, these patients still have viral replication as confirmed or abnormal liver function, can be used as the treatment of lamivudine object. But the case of decompensation should be used with caution, where there are severe jaundice, and withdrawal bleeding indications of the need for strict control and to take active measures to prevent the sudden deterioration of the disease. 2.3 The state of immune tolerance to deal with this is by far not yet solved. Active anti-retroviral treatment programs do not apply in principle, but the deal will not increase the disease progresses. So how to break the immune tolerance state, should attract widespread attention. Cytokines have been proposed, the immune effector cells (CTI) and therapeutic vaccines. Moreover, as triple therapy and traditional Chinese medicine has a certain immune syndrome treatment effect, but should be subject to rigorous clinical trials through to prove the exact effect. 2.4 Viral Syndrome Differentiation new draft April 2002, held in Nanning Medicine Hepatobiliary Association of Chinese Medicine of the National Professional Committee meeting, the proposed new syndrome type program with chronic hepatitis B and C liver syndromes,[link widoczny dla zalogowanych], and that,[link widoczny dla zalogowanych], as far as possible with international and relevant standards formulated by the state to move closer. The new classification scheme made some changes to the original program will be divided into positive chronic hepatitis remain imaginary evil syndrome, liver and gallbladder damp heat syndrome, liver spleen deficiency syndrome, liver and kidney syndrome, liver blood stasis syndrome. Is extensive comments and proposed clinical trial. 2.5 cure chronic hepatitis B tend to predict how the future final solution to the prevention and treatment of chronic hepatitis B are still difficult because need more time and practice. In addition, there are many anti-virus outside of the problem to be solved. Anti-virus for the purposes of this part, have the following measures can be broadly or ways: First, the development of new, more safe and effective antiviral agents, and for clinical validation (Adeforir, Entecavir, FTC, Clevu-dine, etc.); II is the effective combination of drugs, such as the combined antiviral and immune modulators. Main objective is to improve the efficacy and reduce toxicity and reduce the virus mutates. Including the sequential therapy, Ji Xi inhibit rapid and sustained HBV replication. Third, Integrative Medicine. I dark bed Preliminary observations suggest that lamivudine may be increased, and traditional Chinese medicine combined with the negative and HBV-DNA HBV reduce the mutation rate of the treatment of chronic hepatitis B is one good way. Fourth is to strengthen the research of gene therapy, especially in overcoming the preparation, cost, efficacy, methods, safety has made substantial progress and clinical application as soon as possible to the treatment of chronic hepatitis B in the _ to solve the problem, including a large number of asymptomatic carriers (immune tolerance) and application of other means of dealing with cases of treatment failure. Received date; 2oo2.1O a 17
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