拉米夫定治疗慢性乙型肝炎的临床和病理研究

Clinical and pathological study of lamivudine in treatment of chronic hepatitis

目的 :探讨拉米夫定治疗慢性乙型肝炎病人后 ,病人的血清HBV指标和肝组织学的变化。方法 :选择 2 0例慢性乙型肝炎病人 ,口服拉米夫定 ,10 0mg ,qd× 1a。治疗前后 ,检测病人血清ALT ,HBV DNA ,HBeAg ;肝组织活检 ,作病理检查。结果 :治疗后ALT降低 2 0例 (10 0 % ) ;HBV DNA阴转 18例 (90 % ) ;肝组织炎症明显减轻 17例 (85 % ) ;治疗前后比较 ,差异有显著意义 (P <0 .0 5 )。HBeAg阴转 4例 (2 0 % ) ;病人肝组织纤维化减轻 2例 (10 % ) ;治疗前后比较 ,差异无显著意义 (P >0 .0 5 )。结论 :拉米夫定可以有效减轻慢性乙型肝炎病人的肝组织炎症 ,改善病人的肝功能 ,促使病人的血清HBV DNA阴转 。

AIM: To study the indexes of the HBV in the serum and the changes of liver tissues pathological histology on the patients with chronic hepatitis B before and after treatment with lamivudine. METHODS: Twenty patients (F 14, M 6; age 33 a± s 4 a) with chronic hepatitis [HBV DNA(+),ALT>40 U·L -1 ,SB<50 μmol·L -1 ] were treated with lamivudine [100 mg, qd×1 a], ALT, HBV DNA, HBeAg in the serum were detected, and the changes of the liver tissue were examined with pathological methods pre and post therapy. RESULTS: After treatment with lamivudine, of the patients with chronic hepatitis B; 20 patients (100%) ALT were decreased, 18 patients (90%) HBV DNA were got negative express; 17 patients (85%) were remarkably reduced in the inflammatory activity of the liver tissues, the results were significantly difference ( P <0.05); 2 patietns (10%) weren't remarkably reduced in the liver tissues fibrosis activity, 4 patients (20%) HBeAg were got negative express. But the results weren't significantly differene ( P > 0.05) . CONCLUSION: Lamivudine may improve the liver function, and the HBV DNA gotten negative, and reduce the inflammatory activity. But it may not made HBeAg gotten negative and reduce the liver tissues fibrosis activity of liver tissues for patients with chronic hepatitis B.