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目的:观察拉米夫定对肾上腺皮质激素(激素)治疗的肾病综合征患者乙型肝炎病毒(hepatitisBvirus,HBV)复制的防治效果。方法:8例肾病综合征伴HBV标志物阳性患者口服足量泼尼松或甲泼尼龙,同时口服拉米夫定治疗3个月以上,观察血清HBVDNA滴度、HBV标志物及ALT、AST的变化。结果:拉米夫定治疗1个月后血清HBVDNA滴度由(6.9±2.8)×108copy/mL下降至(3.0±1.9)×108copy/mL(P<0.05),治疗3个月后下降至(1.1±0.6)×108copy/mL(P<0.01),8例中2例病人治疗后血清HBVDNA滴度阴转,其中1例HBsAg、抗-HBe及抗-HBc阳性患者治疗2个月后血HBVDNA滴度阴转,ALT、AST正常,但无1例HBeAg阴转。结论:拉米夫定对激素治疗的肾病综合征患者的HBV复制有防治作用。
Objective: To observe the effect of lamivudine on hepatitis B virus (HBV) replication in patients with nephrotic syndrome treated with corticotropin (hormone). Methods: Eight patients with nephrotic syndrome and HBV markers were given oral prednisone or methylprednisolone orally, while oral lamivudine for more than 3 months. The serum HBV DNA titer, HBV markers, ALT and AST Variety. Results: After 1 month of lamivudine treatment, serum HBVDNA titer decreased from (6.9 ± 2.8) × 108copy / mL to (3.0 ± 1.9) × 108copy / mL (P <0.05) 1.1 ± 0.6) × 108copy / mL (P <0.01). Serum HBVDNA titer was negative in 2 patients after treatment in 2 of 8 patients, including 1 HBsAg, anti-HBe and anti-HBc in 2 months after treatment Negative titers, ALT, AST normal, but no case of HBeAg negative. Conclusion: Lamivudine can prevent and treat HBV replication in patients with nephrotic syndrome treated with hormone therapy.