拉米夫定治疗乙型肝炎后失代偿期肝硬化的临床研究

Clinical study on lamivudine in the treatment of patients with decompensation cirrhosis post viral hepatitis B

目的 :探讨拉米夫定治疗乙型肝炎后失代偿期肝硬化的临床疗效。方法 :48例乙型肝炎后失代偿期肝硬化患者给予拉米夫定 1 0 0mg·d-1 ,po ,疗程 1年 ,观察患者的临床表现 ,血清总胆红素 (TBil)、谷丙转氨酶(ALT)、白蛋白、HBV DNA、Child Pugh分值的变化。结果 :48例患者死亡 1 0例 (2 0 .8% ) ,治疗前后TBil,ALT和Child Pugh分值均明显降低 [治疗前后TBil分别为 (68.8± 1 5 .5)和 (2 7.2± 6 .4) μmol·L-1 (P <0 .0 5) ,ALT分别为(1 0 5 .4± 1 6 .5)和 (42 .5± 9.7)U·L-1 (P <0 .0 1 ) ,Child Pugh分值分别为 (1 0 .4± 0 .3)和 (7.4± 0 .5) (P <0 .0 5) ]。血清白蛋白明显升高 ,治疗前后分别为 (2 7.2± 0 .6)和 (34 .6± 1 .0 )g·L-1 (P <0 .0 5) ,HBV DNA阴转 2 2例 (57.9% )。结论

Objective:To study the clinical efficacy of lamivudine in the treatment of decompensation cirrhosis post viral hepatitis B.Methods:48 patients with decompensation cirrhosis post viral hepatitis B accepted lamivudine therapy (100mg,qd) for one year by oral administration.Then the change of serum TBil,ALT,ALB,HBV DNA,the value of Child Pugh and the clinical manifestation were observed in all the patients. Results:10 patients (20.8%) died during this period. The levels of serum TBil,ALT and the value of Child Pugh were significantly lowered after the treatment[TBil:(68.8±15.5)vs(27.2±6.4)μmol ·L -1 , P <0.05;ALT:(105.4±16.5)vs(42.5±9.7) U·L -1 , P < 0.01;the value of Child Pugh:(10.4±0.3) vs (7.4±0.5), P <0.05].The serum ALB was significantly elevated after the treatment[(27.2±0.6) vs (34.6±1.0)g·L -1 , P <0.05].The serum HBV DNA of 22 patients (57.9%) became negative after the treatment.Conclusion:Lamivudine is safe and effective in the treatment of decompensation cirrhosis post viral hepatitis B. [