拉米夫定治疗84例慢性乙型肝炎患者的临床疗效观察

Clinical Response Observation on Lamivudine to 84 Patients with Chronic Hepatitis B

目的:研究拉米夫定对血清乙型肝炎病毒-脱氧核糖核酸(HBV-2DNA)阳性的慢性乙型肝炎病毒感染患者的疗效和安全性。方法:84例患者随机分成拉米夫定治疗组(43例)和对照组(41例)。治疗组每日口服拉米夫定100mg,疗程1年,对照组采用一般保肝、退黄、降酶治疗。结果:治疗组累计67.77%患者血清HBV-DNA阴转,最终持续阴转率67.44%。对照组HBV-DNA累计阴转率14.63%,最终阴转率为9.76%,两组疗效比较P<0.01。治疗前丙氨酸转氨酶(ALT)增高的患者,52周时治疗组的复常率77.14%,对照组为18.18%,P<0.01。52周时治疗组患者血清HBeAg最终持续阴转率40%,对照组HBeAg最终阴转率为7.14%,两组疗效比较P<0.05。两组不良反应发生率比较,差别无显著性P>0.05。结论:拉米夫定能明显降低血清HBV-DNA水平,促使ALT恢复正常,不良反应轻,耐受性好。

Objective： to research Lamivudine＇s efficacy and safety on chronic Hepatitis B patients with HBV -2DNA positive. Methods：classifying the 84 patients into Lamivudine treatment group （43 patients） and control group （41 patients）; treatment group taking 100mg Lamivudine orally per day for one year, and liver protecting, receding jaundice and reducing enzyme measures on control group. Results： 67.77% of treatment group patients＇ HBV-DNA turning to negative and final negative-conversion rate reaching 67.44%; accumulative negativeconversion rate of control group being 14.63%, final negative-conversion rate 9.76; the efficacy comparison of the two groups P 〈 0.01. For patients with high ALT before treatment, 77.14% patients in treatment group returns to normal after 52 weeks treatment, 18.18% in control group, P 〈 0.01. HBeAg negative-conversion rate of treatment group after 52 weeks＇ treatment is 40%, 7.14% in control group, P 〈 0.05. Comparing side effects incidence, no significant difference is found P 〉 0.05. Conclusion：Lamivudine can visibly reduce HBV-DNA in serum and restore ALT to normal with few side effects and good tolerance.