拉米夫定治疗乙型肝炎病毒感染128例的疗效评价

目的　观察拉米夫定 (Lamivudine)对乙型肝炎病毒 (HBV)感染者的疗效及安全性。方法　 2 37例HBV感染者随机分为两组 ,治疗组 12 8例用拉米夫定每日 15 0mg治疗 4 8w ,对照组 10 9例常规保肝治疗。治疗第 8、16、2 4、4 8w分别检测HBVM、HBVDNA半定量、ALT等。结果　治疗组第 8、16、2 4、4 8wHBVDNA阴转率分别为5 2 3%、82 0 %、96 1%、89 1% ,均高于对照组 (P <0 0 5 ) ;治疗组HBeAg阴转率分别为 7 0 %、2 8 9%、71 9%、6 6 4 % ,后 3者高于对照组 (P <0 0 5 ) ;ALT复常率在第 8、16、4 8w分别为 89 1%、97 7%、98 4 % ,后者高于对照组(P <0 0 5 )。治疗组未发现明显拉米夫定相关性严重不良反应。结论　拉米夫定可有效降低患者血清HBVDNA水平 ,明显提高HBeAg阴转率 ,使ALT恢复正常 ,副反应轻而安全。

Efficiency Evaluation of Lamivudine in the Treatment of 128 Patients with HBV Infection

Objective To observe the efficiency and safety of lamivudine in the treatment of HBV infection. Methods 237 cases were divided into two groups randomly, group A of 128 cases treated with lamivudine, and group B of 109 cases as the control. Patients of group A were administered lamivudine 150mg a day for 48 weeks and routine nonspecific drugs. Patients of group B were administered only routine nonspecific drugs. HBV serological markers, HBV DNA, and ALT were detected at 8 th, 16 th, 24 th, 48 th week. Results In the group A, HBV DNA negative conversion rates at 8 th, 16 th, 24 th, 48 th week were 52 3%, 82 0%, 96 1%, 89 1%, respectively, which were higher than those in the group B (P<0 05). HBeAg negative conversion rates of group A at 8 th, 16 th, 24 th, 48 th week were 7 0%, 28 9%, 71 9%, 66 4%, respectively. HBeAg negative conversion rates of group A at 16 th, 24 th, 48 th week were higher than those in the group B (P<0 05). ALT normalization rates of group A at 8 th, 16 th, 48 th week were 89 1%, 97 7%, 98 4%, and the latter was significantly higher as compared with that in the group B (P<0 05). No serious side effect correlating to lamivudine was found.Conclusion Lamivudine can effectively clear serum HBV DNA, increase HBeAg negative conversion rate, and normalize ALT. Lamivudine was safe and its side effect was small.