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目的观察拉米夫定治疗乙型肝炎病毒相关性肾炎(HBV-GN)的临床治疗效果。方法12例HBV-GN患者给予拉米夫定100mg,每天1次口服,共治疗24周。观察治疗前、后HBeAg、HBV DNA、ALT、肾功能和24h尿蛋白定量等项指标的变化。结果在12例接受拉米夫定治疗的患者中,显效4例(33.33%),有效5例(41.67%),无效3例(25.00%)。治疗前,12例HBV-GN患者HBeAg均为阳性,血清HBV-DNA水平为(6.17±2.35)log10mEq/ml,ALT(119.25±27.08)U/L。拉米夫定治疗24周后,HBeAg的阴转率为33.33%;与治疗前比较,HBV-DNA(3.22±1.74 log 10mEq/ml)、ALT(48.00±12.50 U/L)水平显著地下降(P<0.05)。结论拉米夫定对减轻HBV-GN患者肝脏、肾脏组织的损害具有一定的疗效。
Objective To observe the clinical efficacy of lamivudine in the treatment of hepatitis B virus associated nephritis (HBV-GN). Methods Twelve patients with HBV-GN were given lamivudine 100mg once daily for 24 weeks. The changes of HBeAg, HBV DNA, ALT, renal function and urinary protein in 24 hours before and after treatment were observed. Results Of the 12 patients who received lamivudine, 4 (33.33%) were effective, 5 (41.67%) were effective and 3 (25.00%) were ineffective. Before treatment, HBeAg was positive in 12 patients with HBV-GN. Serum HBV-DNA levels were (6.17 ± 2.35) log10 mEq / ml and ALT (119.25 ± 27.08) U / L, respectively. After 24 weeks of lamivudine treatment, the negative conversion rate of HBeAg was 33.33%. The levels of HBV DNA (3.22 ± 1.74 log 10 mEq / ml) and ALT (48.00 ± 12.50 U / L) were significantly lower than those before treatment P <0.05). Conclusions Lamivudine has a certain curative effect on reducing the damage of liver and kidney tissue in patients with HBV-GN.