拉米夫定辅助治疗肺结核合并乙型肝炎的临床观察

Clinical Observation on the Lamivudine in the Adjuvant Treatment of Hepatitis B Combined with Pulmonary Tuberculosis

目的:探讨拉米夫定辅助治疗对肺结核合并乙型肝炎患者的肝功能的影响和安全性。方法:选择2009年1月至2013年6月在我科门诊就诊或住院的肺结核合并乙型肝炎患者84例,随机均分为对照组与观察组,对照组给予常规治疗措施,观察组在上述基础上加用拉米夫定治疗,检测和比较两组患者治疗前和治疗后6个月相关临床指标及不良反应的发生情况。结果:治疗前,两组患者的总胆红素(TBIL)、丙氨酸转氨酶(ALT)、谷草转氨酶(AST)和HBV-DNA定量结果比较,差异均无统计学意义(均P>0.05);治疗6个月后,观察组以上指标均显著低于对照组,差异均具有统计学意义(均P<0.05)。两组患者治疗过程中均出现恶心、腹胀、乏力、肝区不适与肝功能损害,观察组以上不良反应的发生率均显著低于对照组,差异具有统计学意义(均P<0.05)。结论:在肺结核合并乙型肝炎患者的抗结核药物治疗过程中加用拉米夫定不仅可显著抑制患者肝功能的损害,且安全性性更高。

Objective： To observe the clinical effect and security of the Lamivudine on the adjuvant treatment of patients with the Hepatitis B and pulmonary Tuberculosis. Methods： 84 patients with hepatitis B and pulmonary tuberculosis who were treated in our hospital from January 2010 to June 2013 were selected and randomly divided into the control group and the observation group. Then the clinical indicators were detected and the adverse reactions of patients were compared between two groups. Results： There was no significant in the TBIL, ALT, AST, HBV-DNA quantification between the two groups before the treatment（P〉0.05）, the above indicators of observation group were all lower than that of control group with statistically significant differences （P〈0.05）. The adverse reactions such as the nausea, the bloating, the fatigue, the liver discomfort and liver damage during the treatment in the observation group were all significantly lower than those of the patients in the control group （P〈0.05）. Conclusion： It should add the lamivudine in treating the patients with hepatitis B combined with pulmonary tuberculosis, it could not only significantly inhibit the liver function damage, but could also improve the security.