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目的观察合并乙肝病毒(HBV)感染的原发性肾病综合征患者激素治疗过程中拉米夫定对HBV复制的防治效果。方法观察组18例合并HBV感染的原发性肾病综合征患者同时口服强的松及拉米夫定治疗;另外历史对照组20例患者未接受拉米夫定治疗,观察两组患者治疗前、治疗后血清HBVDNA定量、肝肾功能、尿蛋白定量的改变情况。结果观察组肝功能损害的发生率为13.3%,HBVDNA定量下降,对照组肝功能损害的发生率为44.4%,HBVDNA定量升高。结论合并HBV感染的原发性肾病综合征患者在激素同时预防应用拉米夫定能有效抑制HBVDNA复制,减少肝功能损害的发生率。
Objective To observe the effect of lamivudine on HBV replication during steroid therapy in patients with primary nephrotic syndrome complicated by hepatitis B virus infection. Methods 18 patients with primary nephrotic syndrome complicated by HBV infection were treated with both prednisone and lamivudine orally. In addition, 20 patients in the historical control group did not receive lamivudine treatment. Before and after treatment, Serum HBVDNA after treatment, liver and kidney function, urinary protein quantitative changes. Results The incidence of hepatic dysfunction in observation group was 13.3%, and the level of HBVDNA was decreased. The incidence of liver dysfunction in control group was 44.4%, and the level of HBVDNA was increased. Conclusions In patients with primary nephrotic syndrome complicated by HBV infection, simultaneous use of hormone and prophylactic lamivudine can effectively inhibit HBVDNA replication and reduce the incidence of hepatic dysfunction.