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将 45例慢性重型乙型肝炎患者随机分为治疗组 2 2例、对照组 2 3例。治疗组在综合保肝治疗的基础上口服拉米夫定 10 0 mg、每日 1次 ,对照组仅用综合保肝治疗 ,疗程均为 1年 ;观察症状、体征、肝功能、血清HBVM和 HBVDNA的变化。结果显示 ,治疗后两组患者症状体征均有一定程度的改善 ;治疗结束时 ,治疗组治愈好转率 (95 .45 % )高于对照组 (73.91% ) ,病死率 (4 .5 % )低于对照组 (17.39% ) ,P均 <0 .0 5。治疗前治疗组 13例 HBVDNA阴性、9例阳性 (6 5 0 .47± 5 97.2 2 fg/ ml) ,治疗后阴性者持续阴性 ,阳性者均逐渐转阴 ;对照组 15例HBVDNA阴性、8例阳性 (5 79.5 2± 5 42 .86 fg/ ml) ,治疗后阴性者 6例阳转 ,阳性者持续阳性。治疗 3个月时 ,治疗组 AL T复常率高于对照组 ;治疗 8个月后治疗组复发率 4.7% (1/ 2 1) ,对照组为 5 7.14% (8/ 14) ,P<0 .0 1。提示拉米夫定治疗慢性重型乙型肝炎可使病毒持久转阴 ,复发率和病死率低。
Forty-five patients with chronic severe hepatitis B were randomly divided into treatment group (22 cases) and control group (23 cases). The treatment group received 100 mg of lamivudine once a day on the basis of comprehensive hepatoprotective therapy, while the control group was treated with comprehensive hepatoprotective therapy for 1 year. Symptoms, signs, liver function, serum HBVM, Changes in HBVDNA. The results showed that after treatment, the symptom and symptom of both groups improved to a certain extent. At the end of treatment, the improvement rate of the treatment group (95.45%) was higher than that of the control group (73.91%), and the mortality rate (4.5%) was low In the control group (17.39%), P <0.05. Before treatment, 13 cases were negative in HBVDNA, 9 cases were positive (65.07 ± 5 97.2 2 fg / ml), negative after treatment were negative, positive were gradually negative; 15 cases of HBVDNA negative in control group, 8 cases Positive (5 79.5 2 ± 5 42.86 fg / ml). After treatment, 6 cases of positive were positive and positive were positive. At 3 months of treatment, the ALT recovery rate in the treatment group was higher than that in the control group. The recurrence rate was 4.7% (1/21) in the treatment group and 5.114% (8/14) in the control group after 8 months of treatment, P < 0 .0 1. Tip lamivudine treatment of chronic severe hepatitis B can make the virus lasting negative, the recurrence rate and mortality is low.