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放牛哥哥 发表于 2011-6-25 11:11
以上5例可以看出,etv在对付HBV-DNA上还是有功效的,但对于e抗原显得苍白无力。
我记得美版指南里面列举的5 ...
许多不同意.
1)"以上5例可以看出,etv在对付HBV-DNA上还是有功效的,但对于e抗原显得苍白无力。" - 药最重要的是ALT正常化! - ALT表明肝脏炎症和损伤.
2)"我记得美版指南里面列举的5种核苷给药1年后,e抗原血清转换率都在18-22%区间,看来,这个数据未必靠谱。"-- 证据在哪里?
3) "另外,对于etv的耐药率的揣测。我在同济看门诊的时候,一位教授不经意间,说了这么一句话,“我手上已经有十几个恩替耐药的了”。" -
这就是所谓的“传闻(anecdotal)”证据
传闻证据的表达既指证据是不可靠的事实,以及证据可能是真实的,但典型案件樱桃采摘或其他具代表性[1]也就是说,有两种截然不同的含义:
(1)在一个或传闻轶事的形式被称为传闻证据如果有关于它的真实性发生怀疑;证据本身被认为是不可信的。
(2)证据,这本身可能是真实的和可核查的,用来推断的结论不遵循从它通常由一个证据不足的金额概括。
The expression anecdotal evidence refers both to evidence that is factually unreliable, as well as evidence that may be true but cherry-picked or otherwise unrepresentative of typical cases.[1] In other words, there are two distinct meanings:
(1) Evidence in the form of an anecdote or hearsay is called anecdotal if there is doubt about its veracity; the evidence itself is considered untrustworthy.
(2) Evidence, which may itself be true and verifiable, used to deduce a conclusion which does not follow from it, usually by generalizing from an insufficient amount of evidence.
4) etv的耐药率: 真耐药, 或因为患者自己停止服用ETV?
结论:VBT(virological break through) 很普遍接受慢性乙肝患者的临床NUCs
实践中,但近40%的VBTs没有相关的抗病毒药物
阻力。咨询服药坚持和慢性乙型肝炎患者
对VBT和/或GR确认,可避免不必要的抗病毒药物转变
药物。
Conclusion: VBT was common in CHB patients receiving NUCs in clinical
practice, but nearly 40% of the VBTs were not related to antiviral drug
resistance. Counseling of CHB patients on medication adherence and
confirmation of VBT and/or GR can avoid unnecessary changes in antiviral
medications.
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