拉米夫定治疗活动性乙型肝炎肝硬化的临床观察  

Clinical efficacy of Lamivudine in therapy of active cirrhosis resulting from chronic hepatitis B

作　　者：陈美鸿[1] 吴多荣[2] 林庆东[1] 

机构地区：[1]中南大学湘雅医学院附属海口医院感染内科,海南海口570208 [2]中南大学湘雅医学院附属海口医院检验科,海南海口570208

出　　处：《中国现代医学杂志》2006年第19期2979-2981,共3页China Journal of Modern Medicine

摘　　要：目的观察拉米夫定对治疗活动性乙型肝炎肝硬化的疗效。方法将48例活动性乙型肝炎肝硬化患者随机分为治疗组及对照组。治疗组口服拉米夫定100mg,1次/d,对照组口服复方丹参滴丸10丸,3次/d,疗程1年。观察两组血乙肝病毒标志物、肝功能、Child-Pugh计分及血清肝纤维化四项指标(PCⅢ、ⅣC、LN、HA)的变化。结果治疗3个月时,治疗组HBV-DNA阴转率明显高于对照组(P<0.005)。治疗结束时,所有观察指标治疗组均明显优于对照组(P<0.05～P<0.001)。治疗组的肝功能、Child-Pugh计分及血清肝纤维化四项指标与治疗前比较,明显好转(P<0.05～P<0.001)。对照组除ALT、PCⅢ外,治疗前后无显著性的变化。结论拉米夫定对治疗活动性乙型肝炎肝硬化具有良好的抗病毒和改善肝功能的作用,能有效地抗肝纤维化,阻止肝硬化的发展。[Objective] To study the clinical efficacy of Lamivudine in the therapy of active cirrhosis resulting from chronic hepatitis B. [Methods] 48 cases of active cirrhosis resulting from chronic hepatitis B were randomly divided into treatment group and control group. Treatment group was treated with Lamivudine 100 mg orally once daily; control group was treated with compound salvia drop pill 10 pills orally three times daily. The course of treatment in both groups lasted one year. Changes in liver function, Child-Pugh score, blood HBV-DNA, HBV markers and serum indexes of hepatic fibrosis were kept under observation. [Results] Early at first detection of HBV DNA after three months treatment, the negative rate was remarkably higher in treatment group than control group （P 〈 0.005）. At the end of treatment, all parameters were significantly improved in treatment group compared with those in control group（P 〈0.05-P 〈0.001）. Liver function, Child-Pugh score and serum hepatic fibrosis indexes were dramatically improved in Lamivudine group compared with baseline parameters （P 〈0.05-P 〈0.001）, while the control group most parameters showed no remarkable changes except two parameters ALT and PCⅢ （P 〈0.05）. [Conclusion] Lamivudine treatment is beneficial in patients with chronic hepatitis B induced active cirrhosis due to its effective antiviral and antifibrotic action. It can improve liver function and deter the deteriorating process of active cirrhosis.

关 键 词：肝炎 乙型 活动性肝硬化 拉米夫定 疗效 

分 类 号：R512.62[医药卫生—内科学]