拉米夫定治疗慢性乙型肝炎52例

Use of Lamiv udine in Treatment of Chronic B Hepatitis

目的 :观察拉米夫定治疗慢性乙型肝炎的临床疗效。方法 :5 2例HBV -DNA阳性的慢性乙肝患者 ,给予口服拉米夫定 10 0mg ,每天 1次 ,疗程 1年 ,观察血清病毒学指标肝功能变化及药物的不良反应。结果 :5 2例患者中 4 1例HBV -DNA阴转 ,阴转率为 78 85 % ,4 3例治疗前HBeAg阳性者治疗后 2 7例HBeAg阴转 ,转阴率为 6 2 79% ,其中 9例抗 -HBe阳转 ,血清学转换率为 2 0 93%。 5 2例中 33例ALT复常 ,复常率为 6 3 4 6 % ,治疗前ALT水平≥ 2ULN的HBeAg转阴率达 76 4 7% ,治疗前ALT水平 <2ULN的HBeAg转阴率仅 2 9 4 1% ,两者比较有显著性差异 (P <0 0 5 )。 5 2例患者在 1年的治疗过程中未观察到明显不良反应。结论 :拉米夫定可快速持续地抑制HBV -DNA的复制 ,同时可促进HBeAg发生血清学转换并使肝功能恢复正常 。

Objective To evaluate the effect of lamivudine on patients with chronic heaptitis B. Methods Fifty two patients were assigned 100 mg oral lamivudine daily for 1 year. Virological tests were conducted and function of liver and side effect of the drug determined. Results After treatment, 41 of 52(78.85%) patients were seronegative for HBV DNA. Of 43 HBeAg positive patients, 27(62.79%) became seronegative and 9(20.93%) had positive antiHBe. 33 of 52(63.46%) cases had normal ALT level. The negative conversion rates of HBeAg were 76.47% in those whose ALT levle was greater than 2ULN before treatment and 29.41% in those with ALT levle less than 2ULN, respectively, between which there was statistically significant difference ( P<0 05) . No side effect was found in these patients in the one year. Conclusion Lamivudine is both effictive and safe to treat patients with chronical heapitits B because it will inhibit the replication of HBV, promote the negative conversion of HBeAg and help restore the functions of liver.