拉米夫定治疗失代偿性肝硬化38例临床研究

Clinical study on the treatment of 38 cases of decompensation liver cirrhosis by lamivudine

目的观察拉米夫定治疗乙型肝炎失代偿性肝硬化的临床疗效。方法将患者随机分为治疗组38例和对照组35例，治疗组患者使用拉米夫定治疗与护肝治疗，对照组患者仅采用护肝治疗。结果治疗组患者经拉米夫定治疗1～5年后，Child-Pugh分级计分下降，与对照组比较，差异有显著性（P〈0．05）；治疗组乙型肝炎病毒（HBV）DNA和乙型肝炎e抗原（HBeAg）的转阴率分别为92．11％和22．73％，对照组分别为11．43%及5．00％，两组差异有显著性（P〈0．05）；治疗组1～5年的病死率为5．26％，而对照组为22．86％，差异有显著性（P〈0．05）。结论拉米夫定通过抑制HBV的复制，具有控制和部分逆转失代偿性肝硬化病情的作用，使用安全性好。

Objective To observe the therapeutic effect of lamivudine on decompensation liver cirrhosis in hepatitis patients. Methods Thirty-elght and 35 liver cirrhosis patients were randomly divided into treatment and control group respectively, the treatment group patients had taken lamivudine besides liver protective treatment, control group patients only received liver protective treatment. Results In 38 patients of treatment group, after they had taken lamivudine for 1 - 5 years, their Child-Pugh grade scores decreased, there was significant difference compared with that of control group （P〈0. 05） ; the negative transformation rate of HBV DNA and HBeAg was 92. 11 % and 22. 73% respectively; in control group, the negative transformation rate of HBV DNA and HBeAg was 11.43% and 5.00% respectively, there was significant difference between two groups（P〈0. 05）. The mortality between 1 45 years in treatment and control group was 5. 26% and 22. 86% respectively, there was obvious difference between two groups （P〈0.05）. Conclusion Lamivudine may supperss the replication of HBV, thus it can control and partly reverse the development of decompensation liver cirrhosis, it is safe as well.