拉米夫定联合胸腺五肽治疗乙肝相关性肾炎的临床分析  

The efficiency of lamivudine combined with thymopentin in the treatment of hepatitis B virus associated glomerulonephritis

作　　者：刘翠珍[1] 陈梅[2] 孔刚[1] 

机构地区：[1]泰安市中心医院肾病一科,山东271000 [2]泰安市中心医院

出　　处：《社区医学杂志》2015年第12期9-11,共3页Journal Of Community Medicine

摘　　要：目的探讨拉米夫定联合胸腺五肽治疗乙肝相关性肾炎(hepatitis B virus associated glomerulone nephritis,HBV-GN)的临床疗效。方法选择2009年01月—2013年12月收治的48例HBV-GN患者作为研究对象。随机分为对照组23例及观察组25例。对照组给予拉米夫定治疗,观察组在对照组的基础上给予胸腺五肽治疗,两组疗程均为6个月。观察两组临床疗效、24 h尿蛋白定量、血清白蛋白(albumin,ALB)、血肌酐(serum creatinine,Scr)、乙肝病毒标志物及HBV DNA等情况。计量资料组间比较采用t检验,组内比较采用配对t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果观察组总有效率为76.0%,明显高于对照组的47.8%,差异有统计学意义(P<0.05)。观察组HBe Ag转阴14例,占56.0%;对照组6例,占26.1%,差异有统计学意义(P<0.05)。观察组抗HBe转阳16例,占64.0%,对照组5例,占21.7%,差异有统计学意义(P<0.05)。治疗后,观察组ALB、Scr、24 h尿蛋白定量分别为(36.75±0.73)g/L、(81.25±4.28)μmol/L、(0.49±0.15)g,较对照组的(31.28±0.91)g/L、(84.62±3.64)μmol/L、(1.26±0.46)g,差异均有统计学意义(均P<0.05)。结论胸腺五肽联合拉米夫定治疗HBV-GN,可显著降低蛋白尿、升高血清白蛋白、保护肝肾功能。Objective To investigate the effect of lamivudine combined with thymopentin in treatment of hepatitis B virus associated glomerulone nephritis （ HBV - GN）. Methods 48 patients with HBV - GN from January 2009 to December 2013 were randomly divided into observation group （25 cases）and control group （23 cases）. The control group was given lamivudine , and the observation group was given lamivudine combined with thymopentin , both treatment for 6 months. Two groups of clinical curative effect,24 hour urinary protein quantitative, the serum albumin ,liver and kidney function, HBV markers , HBV DNA were observed. Measurement data between groups using t test, in group were compared with paired t - test,counting data by chi - square test, difference was statistically significant by P 〈 0.05. Results Total effective rate of the observation group was 76.0%, significantly higher than that in the control group（47.8% ）, the difference was statisti- cally significant（ P 〈 0.05 ）. 14 cases of the observation with HBeAg negative （56.0%）, 6 cases of the control group （26. 1% ） ,the difference was statistical significance （P 〈0.05）. 16 cases of the observation with Anti -HBe positive （64. 0 % ）, 5 cases of the control group （ 21.7 % ） , the difference was statistical significance （ P 〈 O. 05 ）. Serum albumin, Scr,24 hour urinary protein quantitative of observation group after treatment was （ 36.75 ± 0.73 ） g/L, （ 81.25 ± 4.28 ） μmol/L, （ 0.49 ± 0. 15 ） g, compared with the control group [ （ 31.28 ± 0.91 ） g/L, （ 84.62 ± 3.64） μmol/L, （ 1.26 ± 0.46） g ], the differences were statistically significant（P 〈 O. 05）. Conclusions Thymopentin combined with lamivudine in the treatment of HBV - GN can significantly reduce the proteinuria, increase serum albumin, and protect the liver and kidney function.

关 键 词：拉米夫定 胸腺五肽 乙肝相关性肾炎 血清白蛋白 24 h尿蛋白定量 

分 类 号：R453.9[医药卫生—治疗学]