拉米夫定联合干扰素对乙型肝炎病毒相关性肾小球肾炎的治疗效果

Efficacy of Lamivudine Combined with Interferon in Treatment of Hepatitis B Virus Associated Glomerulonephritis

目的:探讨拉米夫定联合干扰素对乙型肝炎病毒相关性肾小球肾炎的治疗效果。方法:110例乙型肝炎病毒相关性肾小球肾炎(HBV-GN)患者分为对照组(n=54)和观察组(n=56),对照组给予拉米夫定[0.5 mg/(kg·d),治疗12个月],观察组在对照组治疗的基础上给予干扰素(100 m U/m^2,3次/周,治疗16周);分别于治疗前与治疗12个月时,采集2组患者外周空腹静脉血检测血清白蛋白(ALB)、丙氨酸转氨酶(ALT)、血肌酐(Scr)及乙肝病毒脱氧核糖核酸(HBV-DNA)水平,同时收集24 h尿液测定24 h尿蛋白量;随访12个月,记录2组患者恶心呕吐、白细胞下降、肝肾损伤、血糖升高、HBV-DNA定量增高及过敏等不良反应发生率。结果:治疗12个月时,2组患者血清ALT、Scr、HBV-DNA及24 h尿蛋白水平低于治疗前,血清ALB水平高于治疗前,观察组变化更显著(P<0.05);治疗12个月时,观察组总有效率明显高于对照组(P<0.05),观察组总不良反应率明显低于对照组(P<0.05)。结论:拉米夫定联合干扰素治疗HBV-GN疗效优于单纯拉米夫定治疗。

Objective： To investigate the efficacy of lamivudine combined with interferon in the treatment of hepatitis B virus associated glomerulonephritis. Methods： 110 patients with hepatitis B virus associated glomerulonephritis（ HBV-GN） were divided into control group（ n = 54） and observation group（ n = 56）. The control group was given lamivudine（ 0. 5 mg/（ kg · d）,treatment for 12 months）,while the observation group was given interferon（ 100 m U/m-2,3 times a week,treatment for 16 weeks）. Before treatment and 12 months after treatment,fasting venous blood samples were collected from the two groups to detect the levels of serum albumin,alanine aminotransferase,creatinine and Hepatitis B virus deoxyribonucleic acid,and 24 h urine samples were collected for the determination of 24 h urine protein content. The incidences of adverse reactions such as nausea and vomiting,leukopenia,liver and kidney injury,hyperglycemia and quantitative increase of HBV-DNA were recorded after 12 months follow-up. Results： After 12 months of treatment,the levels of serum ALT,Scr,HBV-DNA and 24 h of urinary protein in group 2 were lower than that before treatment,and the serum ALB levels were higher than those before treatment,especially in the observation group（ P〈0. 05）.After 12 months of treatment,the total effective rate in the observation group was significantly higher than that in the control group（ P〈0. 05）,and the total adverse reaction rate in the observation group was significantly lower than that in the control group（ P〈0. 05）. Conclusion： The efficacy of lamivudine combined with interferon in the treatment of HBV-GN is better than that of lamivudine.