拉米夫定治疗慢性乙型肝炎31例临床疗效观察

The clinical effect iveness of lamivudine in treating 31 cases of chronic hepatitis B.

目的 研究拉米夫定对血清乙型肝炎病毒 -脱氧核糖核酸 ( HBV- DNA)阳性的慢性乙型肝炎病毒感染患者的疗效和安全性。方法 61例患者随机分成拉米夫定治疗组 ( 3 1例 )和对照组 ( 3 0例 )。治疗组每日口服拉米夫定 10 0 mg,疗程 1年 ,对照组采用一般保肝、退黄、降酶治疗。结果 治疗组累计 75 %患者血清 HBV- DNA阴转 ,最终持续阴转率70 %。对照组 HBV- DNA累计阴转率 3 3 .3 % ,最终阴转率为 2 3 .8% ,两组疗效比较 P<0 .0 5。治疗前丙氨酸转氨酶( AL T)增高的患者 ,5 2周时治疗组的复常率 83 .8% ,对照组为 2 5 .8% ,P<0 .0 5 ,治疗组累计 5 3 .8%患者血清 HBe Ag阴转 ,最终持续阴转率 5 3 .8%。对照组 HBe Ag累计阴转率 13 .3 % ,最终阴转率为 6.0 % ,两组疗效比较 P<0 .0 5。两组不良反应发生率比较 ,差别无显著性 P>0 .0 5。结论 拉米夫定能明显降低血清 HBV- DNA水平 ,促使 AL T恢复正常 ,不良反应轻 。

Objective To evaluate the effect of lamivudine on the loss of serum HBV DNA,HBeAg/anti HBe seroconversion and alanine transaminase (ALT)levels in chronic hepatitis B patients and its safety profile and tolerance in comparison with control.Methods Sixty one patients had chronic HBV infection as defined by positive HbsAg,HBeAg and HBV DNA were enrolled and randomized into lamivudine and control groups.Thirty one patients received lamivudine 100 mg daily,and 30 patients received conventional treatment.Results During 52 weeks of treatment,75% of patients in the lamivudine group became HBV DNA negative as compared with 33.3% of patients in the control group, P <0.05. 83.8% of the patients with elevated ALT levels at baseline became normal in lamivudine group,whereas only 25.8% of the patients became normal in the control group, P <0.05.Lamivudine was well tolerated in a dose of 100 mg daily and the overall incidence of adverse events was similar to that of control group. Conclusion Lamivudine is effective in the inhibition of HBV replication as indicated by the rapid loss of serum HBV DNA and accompanied by a decrease of serum ALT levels.Lamivudine was well tolerated without severe adverse reaction during treatment in this study.