左旋咪唑搽剂联合拉咪夫啶治疗慢性乙型肝炎对HBeAg血清转换率的影响  

Effect of levamisole liniment combined with lamivudine on HBeAg seroconversion in patients with chronic hepatitis B

作　　者：罗红 聂青和[2] 甘雪婷[2] 

机构地区：[1]武警河北总队医院传染科,石家庄050081 [2]第四军医大学唐都医院全军感染病诊疗中心,西安710038

出　　处：《武警医学》2003年第5期275-277,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的观察左旋咪唑搽剂联合拉咪夫啶治疗慢性乙型肝炎对HBeAg血清转换率的影响。方法 108例慢性乙型肝炎患者根据治疗前血清ALT水平,分为A、B、C 3组,各组随机分为两组,用药方式:(1)联合用药组:左旋咪唑搽剂(LL)5ml均匀涂于四肢皮肤上,2/周,拉咪夫啶(LMI)100 mg口服,1/d,连续用药6个月。(2)单一用药组:拉咪夫啶(LMI)100 mg口服,1/d,连续用药6个月。结果在A、B、C 3组中联合用药组HBeAg血清转换率明显高于单一用药组(P<0.05);治疗前血清ALT>ULN(正常上限)2-5倍者HBeAg血清转换率明显高于ALT在ULN<2倍或正常者。结论联合用药可提高HBeAg血清转换率;治疗前ALT水平也是影响HBeAg血清转换率的一个重要因素。Objective To observe the effect of levamiosle liniment (LL) combined with lamivudine (LMD) on HBeAg seroconversion in patients with chronic hepatitis B[HBeAg seroconversion means disappearance of HBeAg, undectable level of HBV-DNA( < 103 copies/ml, PCR) and appearance of antibody against HBeAg] .Methods According to the alanine transaminase(ALT) values in serum before treatment, 108 patients with HBeAg and HBV-DNA positive chronic HBV infection were randomly divided in to three groups: groups A 23 patients with ALT values over 5 times the upper limit of normal (ULN);groups B, 15 patients with ALT values 2-5 times the ULN;groups C, 16 patients with ALT values below 2 times the ULN.The patients in each group were randomized to receive either LL 5 ml rubbed on skin of limbs two times a week for 6 months in combination with, or LMD alone (monotherapy modality) 100 mg orally once daily for 6 months. Results The rates of HBeAg seroconversion in combination therapy and monotherapy groups were 60.87%(14/23) versus 34.78%(8/23)in group A,53. 33% (8/15) versus 26.67%(4/15) in group B.and 18.75%(3/16) versus 6.25%(1/16) in group C,respectively.Furthermore,the higher the ALT level before treatment was the greater the HBeAg seroconversion would be. Conclusions The combined use of LL and LMD has syn-ergistic effect on promoting HBeAg seroconversion in patients with chronic hepatitis B.The ALT level before treatment is also an important factor influencing HBeAg seroconversion in both combination therapy and monotherapy.

关 键 词：左旋咪唑搽剂 拉咪夫啶 联合治疗 慢性乙型肝炎 HBEAG 血清转换率 

分 类 号：R512.62[医药卫生—内科学]