拉米夫定与泛昔洛韦联合治疗乙型肝炎病毒慢性感染的临床研究

目的 观察拉米夫定与泛昔洛韦联合治疗乙型肝炎病毒(HBV)慢性感染的临床疗效。方法 慢性乙型肝炎患者90例。设联合治疗组28例，单用拉米夫定组30例，单用泛昔洛韦组32例。联合治疗组给予口服拉米夫定0．1g／d(PO)，泛昔洛韦1．5g／d(PO)，24周。拉米夫定、泛昔洛韦单用组剂量及疗程分别同联合治疗组。结果 3组均无明显副反应，丙氨酸转氨酶(ALT)复常率无差异。3组HBV DNA阴转率分别为89．3％、66．7％、40．6％，差异有显著性。乙型肝炎表面抗原(HBeAg)阴转率分别为28．6％、23．3％、21．9％，差异无显著性。结论 拉米夫定与泛昔洛韦联合用药安全、耐受性好，临床显示联合治疗对HBV DNA的抑制作用显著优于单用药。

Treatment of patients with chronic hepatitis B virus infection with lamivudine combined with famciclovir

Objective To evaluate the clinical efficacy of combined treatment with lamivudine and famciclovir on chronic hepatitis B virus (HBV) infection Methods Ninety patients with chronic HBV infection were divided into 3 groups Group one had 28 patients and was treated with combination of lamivudine (0 1 g/d, PO) and famciclovir (1 5 g/d,PO) for 24 weeks Group two and three had 30 and 32 cases, respectively, and were treated with lamivudine 100 mg/day PO and famciclovir (1 5 g/d,PO) alone All the patients had positive markers of HBsAg, HBeAg and anti HBcAg in serum assayed by ELISA and of HBV DNA tested by PCR Results Three strategies of treatment had no different effects on the change of patients' ALT levels The serum HBV DNA became negative after treatment in 89 3% (25/28) of patients treated with combination of lamivudine and famciclovir, 66 7% (20/30) of patients treated with lamivudine, and 40 6% (13/32) of patients treated with famciclovir The rate of serum HBeAg loss in 3 groups were 28 6% (8/28), 23 3% (7/30) and 21 9% ( 7/32 ), respectively Conclusion The combination treatment of lamivudine and famciclovir for chronic HBV infection is safer than and superior to that of either drug alone