复方甘草酸苷联合拉米夫定治疗乙型肝炎相关性肾炎40例  

Treatment of hepatitis B virus-associated glomerulonephritis with compound glycyrrhizin and lamivudine:an analysis of 40 cases

作　　者：杨道坤[1] 孙屹峰[1] 梁海军[1] 申保生[1] 乔汉臣[1] 

机构地区：[1]新乡医学院第一附属医院感染疾病科,河南省卫辉市453100

出　　处：《世界华人消化杂志》2010年第13期1380-1383,共4页World Chinese Journal of Digestology

摘　　要：目的:观察复方甘草酸苷和拉米夫定治疗乙型肝炎相关性肾炎的临床疗效.方法:80例乙型肝炎相关性肾炎患者随机分为治疗组和对照组各40例,治疗组给以复方甘草酸苷50mgtidpo,拉米夫定100mgqdpo,2种药物联合使用,疗程1年;对照组给以拉米夫定100mgqdpo,疗程1年.治疗期间停用其他免疫抑制剂及细胞毒药物.观察治疗前后临床指标变化,用药期间尿蛋白排泄情况、血清白蛋白及肝肾功能和所有不良反应.结果:3mo、6mo、12mo治疗组与对照组比较,每24h尿蛋白有显著差异(4.31g±2.18gvs5.89g±3.01g,2.34g±1.57gvs4.25g±2.27g,1.59g±0.64gvs3.43g±2.12g,均P<0.05),血白蛋白也有显著差异(28.26g/L±2.15g/Lvs23.65g/L±6.13g/L,30.54g/L±2.58g/Lvs27.36±2.23g/L,35.46g/L±2.12g/Lvs31.35g/L±3.35g/L,均P<0.05).结论:复方甘草酸苷联合拉米夫定治疗乙型肝炎相关性肾炎疗效好,不良反应少,随着时间的延长拉米夫定出现耐药,须及时加用阿德福韦酯.AIM：To observe the efficacy of compound glycyrrhizin in combination with lamivudine in the treatment of hepatitis B virus-associated glomerulonephritis （HBV-GN）.METHODS：Eighty HBV-GN patients were randomly and equally divided into two groups：control group and treatment group. The treatment group was treated with compound glycyrrhizin in combination with lamivudine,while the control group was treated with lamivudine alone. The treatment lasted one year. During treatment,the use of other immuosuppressive agents or cytotoxic agents was forbidden. The levels of urinary protein and serum albumin,liver and kidney function and adverse reactions were monitored. RESULTS：In months 3,6 and 12,the 24-h uri-nary protein （4.31 g ± 2.18 g vs 5.89 g ± 3.01 g,2.34 g ± 1.57 g vs 4.25 g ± 2.27 g,and 1.59 g ± 0.64 g vs 3.43 g ± 2.12 g,all P 0.05） and serum albumin （28.26 g/L ± 2.15 g/L vs 23.65 g/L ± 6.13 g/L,30.54 g/L ± 2.58 g/L vs 27.36 ± 2.23 g/L,and 35.46 g/L ± 2.12 g/L vs 31.35 g/L ± 3.35 g/L,all P 0.05） differed signifi cantly between the treatment group and the control group. CONCLUSION：Compound glycyrrhizin in com-bination with lamivudine has better effi cacy and less adverse effects than lamivudine alone in the treatment of HBV-GN. Some HBV-GN patients may develop HBV resistance to lamivudine with the prolongation of treatment duration. Once la-mivudine resistance is noted,adefovir should be given promptly.

关 键 词：拉米夫定 复方甘草酸苷 乙型肝炎相关性肾炎 联合治疗 

分 类 号：R512.62[医药卫生—内科学]