拉米夫定对肺结核并HBV感染患者的作用及意义

The effect and significance of Lamivudine in treating pulmonary tuberculous complicated with HBV infections

目的:观察拉米夫定对肺结核并乙型肝炎病毒(HBV)感染患者的作用。方法:标准化疗的41例血清HBV-DNA阳性的肺结核并HBV感染患者,随机分成拉米夫定抗病毒治疗组21例,对照组20例。治疗组用拉米夫定0.1g/d,对照组未用拉米夫定。两组患者均随访至4.3年。结果:化疗中,肺结核并血清HBV-DNA阳性抗病毒组,肺结核并血清HBV-DNA阳性未抗病毒组,肺结核并HBV-DNA阴性、其他HBV-M阳性组,单纯肺结核组,肝功能受损率分别为28.57%,95.00%,9.68%及5.07%。肺结核并血清HBV-DNA阳性,未抗病毒组死亡与肝病直接相关。结论:肺结核并HBV感染,且HBV复制,化疗中应用拉米夫定有重要意义,是治疗肺结核并HBV感染的一种新型有效的方法。拉米夫定抗HBV治疗,对改善存在HBV复制的肺结核患者预后有重要作用。

Objective： To observe the effects of Lamivudine in treating pulmonary tuberculous complicated with Hepatitis B virus （HBV） infections. Methods：41 patients with pulmonary tuberculosis complicated with HBV infections were divided into two groups randomly, 21 patients in treating group and 20 patients in control group. On the basis of antituberculous chemotherapy, the treating group were treated by Lamivudine, and the control group were not treated by Lamivudine. The patients had been followed up for 4.3 years. Results： In the course of antituberculous chemotherapy ,the abnormal Liver function rate turned to be 95.00%, in the control group but only 28.57%, and only 9.68% and 5.07% in the negatives, HBV-DNA group and pulmonary tuberculosis group respectively. The presence of HBV-DNA in patients with pulmonary tuberculosis was associated with high mortality rate and the cause of death was related to hepatic failure. Conclusion： The efficiency of Lamivudine and antituberculous chemotherapy to cure pulmonary tuberculous complicated with HBV inefections was remarkable. It could be a new efficient way on treating pulmonary tuberculous, complicated with HBV inefections. Lamivudine and antituberculous chemotherapy of antiviral therapy for patients with pulmonary tuhercalosis who had detectable HBV-DNA may improve prognosis.