大剂量联苯双酯治疗血清甲胎蛋白水平升高的慢性乙型肝炎的初步观察

Effects of large dose of dimethyl diphenyl bicarboxylate on chronic hepatitis B with high serum level of alpha-fetoprotein: A report of 26 cases

目的观察大剂量联苯双酯（DDB）对血清甲胎蛋白（AFP）水平升高的慢性乙型肝炎的疗效。方法26例血清AFP水平升高的慢性乙型肝炎患者采用DDB治疗，剂量为67．5mg／d（22．5mgtid）～135mg／d（45mg tid），连续治疗。治疗期间每隔4周检测AFP、肝肾功能。结果治疗后主要症状均有明显改善（P〈O．01）；治疗后AFP水平较治疗前明显降低（52．3±92．6ug／L对280．O±315．2tug／L，卢3．5338，P〈0．001）；治疗后血清ALT、AST水平均较治疗前明显下降（P〈0．05～0．001）。未见明显副作用。结论DDB对血清AFP升高的慢性乙型肝炎有明显的治疗效果，除了保肝降酶作用外，它还可降低血清AFP水平。

Obsjective To observe the effects of large dose of dimethyl diphenyl bicarboxylate（DDB） on chronic hepatitis B with high serum level of alpha-fetoprotein（AFP）. Methods Twenty-six patients with chronic hepatitis B with high serum AFP level received DDB treatment at doses of 67.5mg/d（22.5mg tid） to 135mg/d（45mg tid） for 24 weeks or longer. Results The symptoms of hepatitis were dramatically ameliorated with DDB treatment in all patients. The serum levels of AFP after DDB treatment were significantly lower than those before DDB treatment （52.3＋92.6μg/L vs. 280.0 q- 315.2,μg/L, t= 3. 5338, P〈 0.001 ） ; The serum levels of alanine aminotransferase （ALT） and aspartate aminotransferase（AST） after DDB treatment were also significantly lower than those before DDB treatment （P 〈0.05-0. 001）. No obvious side-effects were observed. Conclusions DDB might decrease serum AFP levels in patients with chronic hepatitis B in addition to ameliorating symptoms and lowering rapidly serum aminotransferases.