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目的:观察拉米夫定对肺结核并乙型肝炎病毒(HBV)感染患者的作用。方法:标准化疗的41例血清HBV-DNA阳性的肺结核并HBV感染患者,随机分成拉米夫定抗病毒治疗组21例,对照组20例。治疗组用拉米夫定0.1g/d,对照组未用拉米夫定。两组患者均随访至4.3年。结果:化疗中,肺结核并血清HBV-DNA阳性抗病毒组,肺结核并血清HBV-DNA阳性未抗病毒组,肺结核并HBV-DNA阴性、其他HBV-M阳性组,单纯肺结核组,肝功能受损率分别为28.57%,95.00%,9.68%及5.07%。肺结核并血清HBV-DNA阳性,未抗病毒组死亡与肝病直接相关。结论:肺结核并HBV感染,且HBV复制,化疗中应用拉米夫定有重要意义,是治疗肺结核并HBV感染的一种新型有效的方法。拉米夫定抗HBV治疗,对改善存在HBV复制的肺结核患者预后有重要作用。
Objective: To observe the effect of lamivudine on patients with pulmonary tuberculosis and hepatitis B virus (HBV) infection. Methods: 41 patients with positive HBV-DNA-positive tuberculosis and HBV infection under standard chemotherapy were randomly divided into lamivudine antiviral therapy group (21 cases) and control group (20 cases). The treatment group with lamivudine 0.1g / d, the control group without lamivudine. Two groups of patients were followed up to 4.3 years. Results: In chemotherapy group, the positive rates of HBV DNA positive group, tuberculosis group and serum HBV-DNA positive group were not significantly different from those of the positive group, but negative for HBV-DNA, other HBV-M positive group and simple pulmonary tuberculosis group The rates were 28.57%, 95.00%, 9.68% and 5.07% respectively. Tuberculosis and serum HBV-DNA positive, no anti-virus group of deaths and liver disease are directly related. Conclusion: It is of great importance to use lamivudine for HBV replication and chemotherapy in patients with pulmonary tuberculosis and HBV infection. It is a new and effective method for the treatment of pulmonary tuberculosis and HBV infection. Lamivudine anti-HBV treatment, to improve the presence of HBV replication in patients with tuberculosis prognosis has an important role.