拉米夫定对58例慢性活动性乙型肝炎治疗效果分析

目的研究拉米夫定治疗慢性乙型肝炎抗病毒及临床疗效.方法将114例HBVDNA为阳性的慢性活性乙型肝炎,随机分为治疗组58例,对照56例,两组均采用基本护肝对症治疗,治疗组加用拉米夫定100mg口服,每日1次,疗程一年,观察其血清病毒学指标,肝功能及临床转归.结果治疗组与对照组血清转换率分别为17.8%(10/56)和4%(2/50).两组治疗前HBV DNA含量均值分别为(28±0.92)×106拷贝/ml和(29±0.87)×106拷贝/ml,(P＞0.05),治疗后治疗组有37例1个月后转为0拷贝/ml,3例6个月后转0拷贝/ml,1年后持续0拷贝/ml,其余52例持续1年均为阳性,两组比较差异有显著性(P＜0.01).两组治疗前血清丙氨酸转氨酶(ALT)分别为(196±10)U/L和(186±13)U/L(P＞0.05),1年后分别为(31±3)U/L和(108±10)U/L(P＜0.01).两组治疗前总胆红素(TBil)分别为(45±5.0)umol/L和(42±6.1)umol/L(P＞0.05),治疗后TBil恢复正常比例分别为100%(58/58)和32%(18/56)(P＜0.01).治疗组病情稳定,均达到临床治愈,无再次入院者,随访半年亦无一例死亡,亦无不良反应;对照组肝功能反复波动,持续不能降至正常者有34例,再次入院者有20例,3次入院者有11例,其中3例病情逐渐加重,抢救无效死亡.结论拉米夫定是安全高效的抗HBV药物,无论HBeAg是否阳性,只要HBV DNA为阳性,接受拉米夫定治疗可缩短住院时间,防止病情复发和加重.

Objective Study the antiviral effect and chinical curative effect of Lamivudine for chronic active hepatitis B.Methods 114 patients were chronoic active hepatitis B with HBV DNA positive, they were divided into two group at random,58 cases in the therapy group,56 cases in the vontrol group.Two groups were treated with routine protection liver drugs, while the therapy groip received 100mg Lamivudine orally daily for 52 weeks in addition, the items of liver were assayed in all patients. Results The serum vonversion rate in therapy was 17.8% (10/56) , that incontrol group was 4% (2/50). Before treatment, mean HBVDNA concentrations in therapy group were(28 ?