拉米呋啶治疗慢性乙型肝炎疗效观察

Effect of Lamivudine Treatment on the Chronic Hepatitis B

目的 :探讨拉米呋啶治疗慢性乙肝炎病人 1年的临床疗效。方法 :治疗组 6 5例病人 ,每日服拉米呋啶 10 0mg持续 5 2周。对照组 6 5例接受除拉米呋啶和干扰素以外的常规治疗 ,亦为 5 2周。定期检测血ALT、HBV DNA、HBeAg和抗 HBe ,并观察药物副作用。结果 :治疗 5 2周后 ,治疗组和对照组HBVDNA、HBeAg阴转和血清转换分别为 6 1(93 .85 % )例 ,2 3(35 .5 4% )例 ,30 (46 .30 % )例和 5 (7.70 % )例 ,6 (9.2 3 % )和 7(10 .78% )例 (P <0 .0 1)。治疗组治疗前后血ALT( x±s)值分别为 (15 4± 37)U和 (47± 2 6 )U ,P <0 .0 1。治疗 5 2周后 ,治疗组和对照组ALT复常分别为 5 7(87.6 9% )例和 49(75 .38% )例(P >0 .0 5 )。结论 :拉米呋啶能抑制HBV的复制 ,降低血ALT水平 ,促进血清的转换 。

Objective:To evaluate 1 year trial of lamivudine therapy in chronic hepatitis B patients. Methods:65 patients received lamivudine 100mg daily for 52 weeks. 65patients received current treatment except lamivudine and interferon as control.The efficacy and safety were evaluated with clinical, biochemical, hematological and virological parameters.Results:At the 52 weeks, HBV DNA and HBeAg negative, seroconveersion were 61(93.85%),27(41.54%),24(36.92%) and 5(7.70%), 6(9.23%), 4(6.15%) of patients received lamivudine and control treatment ( P <0.01, P <0.01, P <0.01).Before lamivudine treatment and at the 52 weeks ,serum ALT( ±s ) were (154±37)U,(47±26)U( P <0.01).At 52 weeks, ALT normalization (<1×upper limit of normal) (ULN) rate was 92.31 % and 70.77% of patients received lamivudine and control treatment( P <0.01).Conclusion:Oral lamivudine effectively suppressed HBV replication, decreased ALT level improved serum conversion and it was safe.