拉米夫定治疗乙型肝炎肝硬化的临床观察

Lamivudine in the treatment of patients with hepatitis B-induced cirrhosis

目的观察拉米夫定治疗乙型肝炎肝硬化的临床疗效。方法选择Child-Pugh A、B级乙型肝炎肝硬化70例,36例接受拉米夫定治疗2-3年,另34例不规则口服护肝药物。结果治疗或随访至3年时,接受拉米夫定治疗的患者HBeAg阴转、HBeAg/抗HBe血清转换和HBV DNA阴转率分别为50%、44.4%和77.3%,显著高于对照组;Child-Pugh计分为7.5±1.1,而对照组为9.1±1.3（P〈0.05）;两组ALT复常率和发生肝衰竭和肝细胞癌情况无显著性相差。2例HBV相关性肾病患者病情恢复、稳定。结论拉米夫定治疗乙型肝炎肝硬化的临床效果肯定,可以延缓病情进展。

Objective To observe the efficacy of lamivudine in the treatment of patients with hepatitis B-induced cirrhosis. Methods Seventy hepatitis B-induced cirrhotics with Child-Pugh class A or B（2 with class C） were divided at random into two groups. Thirty-six were treated with lamivudine 100 mg, daily for 2 to 3 years, and thirty-four received herbal medicine. Results At the end of 3 year observation, the HBeAg negativity, HBeAg/anti-HBe seroconversion and HBV DNA loss in lamivudine-treated patients were 50% , 44.4% and 77.3% , much higher than in control; the Child-Pugh score was 7.5 ± 1.1 ,lower than 9.1 ±1.3 （P 〈 0.05 ） in control ; but there was no statistical difference with respect to serum alanine aminotransaminase normalization and the occurrence of hepatic failure and carcinoma between the two groups. Conclusion Lamivudine treatment in hepatitis B-induced cirrhosis might improve the life quality of patients.