合并慢性乙型病毒性肝炎的风湿免疫病抗病毒治疗的价值——70例临床分析  

The Value of Antiviral Therapy in Chronic Hepatitis B which with Rheumatological Disease——An analysis of 70 cases

作　　者：曾沛英[1] 王庆文[1] 路晓燕[1] 

机构地区：[1]北京大学深圳医院风湿免疫科,广东深圳518036

出　　处：《罕少疾病杂志》2012年第2期1-4,共4页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨需要接受糖皮质激素和(或)改善病情抗风湿药(DMARDS)治疗的合并慢性乙型病毒性肝炎(HBV)的风湿免疫病的抗病毒治疗价值。方法分析合并HBV的风湿免疫病患者的相关临床资料,进行统计分析。结果合并HBV的风湿免疫病70例,于开始糖皮质激素和(或)DMARDS治疗时同时抗病毒治疗的25例,无一例出现肝功能异常或HBV病毒复制。未经抗病毒治疗的45例,HBVDNA升高10倍以上的24例,伴肝功能异常17例;暴发性肝炎2例,1例10天、1例2月出现症状,谷丙转氨酶(ALT)最高达3428U/L,HBVDNA>10^9copies/ml,经护肝、抗病毒治疗后ALT正常、HBVDNA正常。结论风湿免疫病同时合并HBV常见,治疗风湿免疫病需要应用糖皮质激素和(或)DMARDS,有使稳定的乙型肝炎病毒携带者出现病毒复制,甚至暴发性肝炎的可能,而预先应用抗病毒治疗,可减少病毒复制机会。Objective Explore the value of antiviral therapy for hepatitis B patients with rheumatological disease,who accept the glucocorticoid and（or） DMARDS.Methods Analysis clinical data of rheumatological patients with HBV.Results 70 cases of rheumatological disease with HBV patients.25cases accept antiviral treatment at the beginning,none appear abnormal liver function or HBV viral replication.45 cases without antiviral treatment,24 cases of the HBVDNA increased more than 10 times,17 cases with hepatic dysfuntion,2 cases with fulminant hepatitis.Conclusion The rheumatological disease with HBV is common.The treatment of rheumatological diseases frequently used glucocorticoids and（or） DMARDS,may lead the hepatitis B virus replication,and even the possibility of fulminant hepatitis.Pre-application of antiviral therapy can reduce viral replication opportunities.

关 键 词：风湿免疫病 改善病情抗风湿药(DMARDS) 慢性乙型病毒性肝炎 抗病毒 

分 类 号：R5[医药卫生—内科学]