拉米夫定和干扰素a-2b治疗慢性乙肝停药后临床观察

The clinical observation of the treatment of chronic B hepatitisafter using Lamivuding and INFa-2b

目的:评估拉米夫定治疗慢性乙型肝炎长期疗效。方法:慢性乙型肝炎患者69例,随机分为治疗组Ⅰ35例和治疗组Ⅱ34例,治疗组Ⅰ单用拉米夫定,治疗组Ⅱ用拉米夫定加干扰素a-2b(联合、序贯),观察停药后肝功能,HBeAg及HBVDNA的变化。结果:治疗组Ⅰ在停用拉米夫定后出现肝炎复发率为68.57%(24/35),ALT反跳率77.42%(24/31),HBeAg复阳率70%(7/10),HBVDNA复阳率71.43%(20/28);治疗组Ⅱ在疗程结束后出现肝炎复发率为(16/34)47.06%,ALT反跳率55.17%(16/29),HBeAg复阳率40.0%(6/15),HBVDNA复阳率51.85%(14/27),治疗组Ⅰ与治疗组Ⅱ比较,复发率、ALT反跳率、HBeAg复阳率、HBVDNA复阳率有显著差异(P<0.05)。结论:拉米夫定加干扰素a-2b(联合、序贯)治疗慢性乙肝获得应答患者停药后其复发率、HBV复制标志复阳率明显低于单用拉米夫定治疗慢性乙肝获得应答患者。

Objective：To evaluate the long curative effect of Lamivudine in treating chronic B hepatitis. Methods：69 cases were divided randomly into two groups so as to observe liver function and HBeAg/HBV DNA. 35 cases who accepted Lamivudine as control group 1,34 cases who accepted Lamivudine and INFa 2b as control group Ⅱ. Resnlts：The rate of recurrence in control Ⅰ is hepatitis 68.57%（24/35）, ALT 77.42%（24/31 ）, HbeAg 70%（7/10） ,HBV DNA 71.43%（20/28） ;the rate of recurrence in control Ⅱ is hepatitis 47.06%（16/34）,ALT55. 17%（16/29） ,HbeAg40.0%（6/ 15） ,HBV DNA 51.85% （14/27） （P〈0. 05）. Conclusionst Control Ⅱ （ Lamivudin and INFa 2b） have a lower recurrence rate than control Ⅰ in hepatitis, HBV reproduce after the treatment.