血浆置换联合拉米夫定治疗慢性重型乙型肝炎的疗效观察

Therapeutic effect of plasma exchange combined with lamivudine in the treatment of chronic severe hepatitis B

目的研究血浆置换联合拉米夫定治疗慢性重型乙型肝炎的疗效。方法在内科综合治疗基础上对46例慢性重型乙型肝炎患者进行血浆置换联合拉米夫定治疗,观察疗效。结果 治疗1个月患者肝功能、凝血酶原活动度明显改善(P<0.05),乙肝病毒定量明显下降(P<0.05),早、中、晚期患者有效率分别为73.3%、73.7%和33.3%,总有效率为63.0%。早中期有效率高于晚期患者(P<0.05)。结论血浆置换联合拉米夫定治疗慢性重型乙型肝炎可以有效改善肝功能、降低HBVDNA水平,且早中期患者的疗效较晚期好。

Objective To analyze the therapeutic effect of plasma exchange combined with lamivudine in the treatment of chronic severe hepatitis B.Methods 46 patients with chronic severe hepatitis B were treated by plasma exchange combined with lamivudine and basic medical treatment.The therapeutic efficacy was observed.Results After one month of treatment,the liver function,total prothrombin activity were significantly improved（P0.05）.Quantitative hepatitis B virus（HBV） DNA decreased significantly（P0.05）.The effective rate in the early,middle and late stage of chronic severe hepatitis B were 73.3%,73.7% and 33.3% respectively,and the total effective rate was 63%.It was more efficient in patients of early and middle stage than those of late stage（P0.05）.Conclusion In the treatment of chronic severe hepatitis B,plasma exchange in combination with lamivudine can significanly improve liver function and reduce HBV DNA levels,which is proved to be more efficient in patients in early and middle stage of chronic severe hepatitis B.