拉米夫定治疗慢性乙型肝炎临床研究  

Clinical study on one-year Lamivudine treatment for patients with chronic hepatitis B

作　　者：白起福 

机构地区：[1]山西祁县地区第一人民医院,030900

出　　处：《当代医学》2006年第11期68-70,共3页Contemporary Medicine

基　　金：国家自然科学基金(30271171)

摘　　要：目的考察拉米夫定治疗慢性乙型肝炎的疗效和安全性。方法88例人随机分成治疗组和每日服拉米夫定100mg,疗程52周;对照组用易善力2粒,日三次口服,疗程三个月。定期检测ALT、HBeAg和抗HBe．结果87人完成疗程,治疗组于治疗第4w末,有76．3％的患者HBV-DNA阴转,累计阴转率为86．4％,最终阴转率10．3％,两组疗效比较P<0．01。拉米夫定治疗后部分病人出现HBeAg阴转和HBeAg／抗HBe血清转换。其发生与治疗前ALT水平有关。治疗前ALT增高的病人,12w末治疗组的ALT复常率62．5％,对照组为29．4％,p<0．05．两组中无1例HBsAg阴转。两组的不良反应大多为轻度到中度,一般不需停药。结论拉米夫定能抑制HBV DNA的复制,可降低ALT,改善临床症状,大多病人能耐受,不良反应与对照组无显著差别,长期服用是安全的,部分病人产生耐药,停药可反跳。Objective：To observe the efficacy and safety of lamivudine therapy for chronic hepatitis Methods：88 patients were enrolled into lamivudine group and Essentiale group at random.The patients in Lamivudine group were given peroral Lamivudine 100mg daily for 52 weeks and those in Essentiale group were given peroral Essentiale 2 capsules 3times daily for 3 months.Meanwhile,ALT, HBV- DNA,HBeAg and anti-HBe were detected at regular intervals.Results：87patients have completed the course of the treatment.At the end of the 4 week,76.3% of Lamivudine recipients became HBV-DNA netgative.The total rate of HBV-DNA negative was 86.4% and the sustained negative patients for HBV-DNA were 79.7% .In contrast,at the end of the 4th week,no patients in the Essentiale group had HBV- DNA loss and the total rate of HBV-DNA negative was 10.3% ,and the sustained patients for HBV-DNA negative were 10.3%.The ratio Of efficacy between the Lamivudine group and the Essentiale group was P〈0.01.Lumivudine therapy resapy resulted in increased HbeAgloss and HBeAg/anti-HBe seroconversion,which were correlated with the ALT levels before trestment.At the end of the 12th week,among the patients With ALT level abnormal before treatment,62.5% of the Lamivudine group decreased to norma ranges,compared with the 29.4% in Essentiale group （P〈0.05）.There was no case for HBsAg loss in the two groups.The adverse drug rdacions of two groups of two groups wer mild to moderate and there is no need to stop. Conclusion：Lamivudine therapy can prevent the HBV-DNA replication effectively, decrease ALT level and improve clinical symptom,and has a good tolerance.There is no significant difference in adverse drug reactions,compared with Essentiale group. It is safe for long-term treatment.Some patients may have drug fast and after they stop taking it, HBV-DNA replication will reoccur to them.

关 键 词：拉米夫定治疗 慢性乙型肝炎 临床研究 HBEAG阴转 ALT水平 DNA阴转 抑制HBV 抗HBE 

分 类 号：R512.62[医药卫生—内科学]