拉米夫定治疗严重急性乙型肝炎患者的疗效分析  

The analysis of efficacy of lamivudine in patients with severe acute hepatitis B

作　　者：于建武[1] 孙丽杰[1] 赵勇华[1] 康鹏[1] 颜炳柱[1] 

机构地区：[1]哈尔滨医科大学附属第二医院感染病科,黑龙江150086

出　　处：《肝脏》2011年第5期363-366,共4页Chinese Hepatology

摘　　要：目的观察拉米夫定治疗严重急性乙型肝炎患者的疗效。方法 80例严重急性乙型肝炎患者随机分为拉米夫定组40例和对照组40例。观察两组患者HBV DNA、ALT、TBil和凝血酶原活动度(PTA)的变化,比较两组患者HBsAg、HBeAg血清转换率、HBV DNA阴转率。数据行t和x^2检验。结果治疗1、2周时拉米夫定组HBV DNA阴转率分别为70.0%(28/40)和95.0%(38/40),明显高于对照组的47.5%(19/40)和80.0%(32/40))(x^2=4.178,4.1 14;P=0.041,0.043)。1、2周时拉米夫定组PTA复常率为60.0%(24/40)和82.5%(33/40),明显高于对照组的37.5%(15/40)和62.5%(25/40)(x^2=4.053,4.013;P=0.044,0.045)。4周时拉米夫定组TBil复常率77.5%(31/40)明显高于对照组的55.0%(22/40)(x^2=4.528;P=0.033)。1年时拉米夫定组HBsAg和HBeAg血清转换率为62.5%(25/40)和70.0%(28/40),明显低于对照组的85.0%(34/40)和90.0%(36/40)(x^2=5.230,5.000;P=0.022,0.025)。结论早期应用拉米夫定治疗严重急性乙型肝炎,能迅速降低HBV DNA水平,改善肝功能,但HBsAg和HBeAg血清转换率降低。Objective To evaluate the efficacy of lamivudine in patients with severe acute hepatitis B. Methods Eighty patients with severe acute hepatitis B were randomly divided into the lamivudine treatment group （n = 40） and the control group （n = 40）. The levels of serum HBV DNA, ALT, total bilirubin （TBil） and prothrombin activity （PTA） of patients in two groups were investigated. HBsAg, HBeAg seroconversion rates and HBV DNA negative rate of patients in two groups were compared. The data were analyzed with t test and Z 2 test. Results The HBV DNA negative rate （70. 0%, 28/40） and （95.0%, 38/40） at the 1st week and the 2st week of lamivudine group were significantly higher than that （47.5%, 19/40）, （80.0%, 32/40） in the control group （X2 =4.178, 4. 114; P =0.041, 0.043）. The PTA normalization rate （60.0%, 24/40） and （82. 5%, 33/40） at the 1st week and the 2na week of lamivudine group were significantly higher than that （37.5%, 15/40）, （62.5o/oo, 25/40） in the control group （χ2 = 4. 053, 4. 013; P = 0. 044, 0. 045）. The TBil normalization rate （77.5%, 31/40） at the 4th week of lamivudine group was significantly higher than that （55.0%, 22/40） in the control group （χ2 = 4. 528; P = 0. 033）. The HBsAg and HBeAg seroconversion rates （62.5%, 25/40） and （70.0%, 28/40） of patients in lamivudine group were significantly lower than those （85.0%, 34/ 40）, （90.0%, 36/40） in the control group （χ2 =5.230, 5.000; P=0.022, 0.025）. Conclusion Early treatment with lamivudine could lower the level of HBV DNA and improve the liver function of patients with severe acute hepatitis B significantly, but significantly decreases HBsAg and HBeAg seroconversion rates.

关 键 词：肝炎 乙型 急性 拉米夫定 

分 类 号：R512.62[医药卫生—内科学]