拉米夫定联合干扰素治疗对慢性乙型肝炎纤维化指标的影响

Effect of lamivudine combined with interferon on index of hepatic fibrosis in chronic hepatitis B

目的观察拉米夫定联合干扰素治疗对慢性乙型肝炎纤维化指标的影响。方法将60例慢性乙型肝炎患者随机分为治疗组和对照组各30例。治疗组采用干扰素α-2b 500万U肌内注射,同时给拉米夫定0.1g口服;对照组仅给予拉米夫定,用法、疗程同治疗组。观察2组治疗前后肝纤维化指标、肝功能及血清病毒学标志物的变化情况。结果 2组治疗后透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原肽(PⅢP)、Ⅳ型胶原(C-Ⅳ)、丙氨酸氨基转移酶(ALT)及天冬氨酸氨基转移酶(AST)均明显降低,差异均有统计学意义(P<0.05或P<0.01);治疗组治疗后HA和C-Ⅳ水平低于对照组,差异有统计学意义(P<0.05)。治疗组HBV-DNA转阴率高于对照组,差异有统计学意义(P<0.05)。结论拉米夫定联合干扰素治疗能明显抑制慢性乙型肝炎患者乙型肝炎病毒复制,明显改善肝纤维化指标,减轻肝纤维化程度,值得临床推广应用。

Objective To observe the effect of lamivudine combined with interferon on index of hepatic fibrosis in chronic hepatitis B. Methods 60 cases patients with chronic hepatitis B were randomly divided into treatment group and con- trol group, each of 30 cases. Treatment group were treated with interferon alpha ct-2b 5 million U intramuscular injection and lamivudine O. 1 g oral; Control group only received lamivudine, usage, course of treatment with the treatment group. Observed the index of hepatic fibrosis, liver function and serum virological marker before and after treatment of two groups. Results After treatment, hyaluronic acid （ HA）, laminin （ LN ） and Ⅲ procollagen peptide （ PⅢ P）, collagen type IV （ C- Ⅳ ）, alanine amin- otransferase（ALT） and aspartate aminotransferase（AST） of two groups were significantly decreased,the difference were statis- ticaUy significant（ P 〈0. 05 or P 〈 0. 01 ） ;After treatment, the level of HA and C-IV were lower than those of control group, the difference was statistically significant（P 〈 0.05 ）. HBV-DNA negative rate of treatment group was higher than that of control group, the difference was statistically significant （ P 〈0. 05 ）. Conclusion lamivudine combined with interferon can restrain replication of HBV in patient with chronic hepatitis B,improve the index of hepatic fibrosis, while relieve degree of hepatic fi- brosis obviously.