拉米夫定联合卡介苗素治疗慢性乙型肝炎疗效观察

Clinical efficacy of E-BCG combined with lamivudine for chronic hepatitis B

目的 :研究联合应用卡介苗素 (E -BCG)与拉米夫定 (3 -TC)治疗慢性乙型肝炎 (CHB)的疗效及其治疗机制。方法 :68例CHB患者随机分为治疗组 (n=37)与对照组 (n=31) ,治疗组给予E -BCG1.0mg,肌注 ,每周3次 ,连续6月 ,与3 -TC(100mg,每日1次 ,连续12个月)联合治疗 ;对照组单独用拉米夫定治疗 ,方法同上。治疗前、治疗2周、4周、8周、12周、16周、20周、26周、52周及停药后6个月分别检测HBV标志物、肝功能、肾功能及HBVDNA定量 ,并记录治疗期间临床和实验室检查发生的一切不良事件。结果 :疗程结束时 ,治疗组ALT复常率、HBeAg阴转率、HBeAg/HBeAb转换率与完全应答率分别为89.2 %、45.9 %、43.2 %与40.5 % ,高于对照组的67.7 %、22.6 %、16.1 %与16.1 % ,差异有显著性 (P<0.05)。疗程结束后6mo,治疗组HBeAg阴转率、HBeAg/HBeAb转换率分别为54.1 %与51.4 % ,明显高于对照组的19.4 %与12.9 % ,差异有非常显著性 (P<0.01)。复发率治疗组为25.0 % ,低于对照组的35.7 % ,差异有显著性 (P<0.05)。HBVDNA阴转率在两组间无显著性差异 (P>0.05)。结论 :采用3 -TC与E -BCG联合治疗CBH ,在提高ALT复常、促进HBeAg阴转与HBeAg/HBeAb转换、降低复发方面 ,较单用3

Objective:To observe the efficacy of extra-bacillus-calmette-guerin(E-BCG)combinated with lamivudine(3-TC)in treatment of chronic hepatitis B(CHB).Methods:68case suffered from CHB were randomly divided into treatment group(n=37)and cotrol group(n=31).Patients in treatment group were treated with1.0mg E-BCG thrice a week for6months and100mg3-TC everyday for12months.Patients in the control group were treated only with3-TC at the same dosage.All the patients had been observed for6months after the treatment.Results:In the treatment group,the recover rate in ALT,the negative transfer rate in HBeAg,the tranfersfer rate fromHBeAg to HBeAb and the full responds rate were89.2%?45.9%?43.2%and40.5%,respectively.In the control group,they were67.7%?22.6%?16.1%and16.1%,the difference of the result was significant(P<0.05).After half a year of follow up,the negative transfer rate in HBeAg and the tranfersfer rate from HBeAg to HBeAb in treatment group and control group were54.4%and51.4%,19.4%and12.9%,respectively.The difference of the result was obviously significant(P<0.01).In the treatment group,the reappearanse rate was25.0%,in the control groupit was35.7%,the differnce was significant(P<0.05).Only the negative transfer rate of HBVDNA was no significant difference between the two groups(P>0.05).Conclusion:Curative effect of3-TC combined with E-BCG is better than that of3-TC singly to improve the recover rate in ALT,the negative transfer rate in HBeAg,the tranfersfer rate from HBeAg to HBeAb,the full responds rate and the reappearanse rate.