拉米夫定联合地塞米松治疗重型乙型肝炎的探讨

目的: 探讨拉米夫定联合地塞米松治疗重型乙型肝炎(SHB)的治疗效果.方法: 将46例SHB患者分成A、B两组.A组在综合治疗基础上加用拉米夫定100 mg,po,qd,地塞米松15～20 mg,静滴 qd,10 d后减量至10 mg静滴qd,5 d后停药;B组采用综合治疗.12周后观察疗效.结果: A组的生存率为(73.9%,17/23)优于B组(39.1%,9/23)(P<0.05);存活者中,A组的HBV-DNA阴转率(82.4%,13/17)明显优于B组(22.2%,2/9)(P<0.01);A组的肝功能及PTA的改善优于B组(P<0.05).结论: 拉米夫定联合地塞米松可改善SHB的肝功能及PTA,提高存活率.

Effect of Lamivudine Combined with Dexamethasone in Treatment of Patiens with Severe Hepatitis B

Objective: To explore the effect of lamivudine combined with dexamethasone in treatment of patients with severe hepatitis B (SHB).Method: Forty-six patients with SHB were randomly divided into groups A and B. Patients in group A received the ordinary synthetic treatment plus lamivudine and dexamethasone,ones in group B received ordinary synthetic treatment only.The results were observed for 12 weeks ofter beginning of the treatment.Result: The survival rate of group A( 73.9% ,17/23) was higher than that of group B( 39.1% ,9/23)(P< 0.05 ).Among the survivals,the percentage of serum HBV-DNA negative conversion in group A was markedly higher ( 82.4 ,13/17) than that in group B( 22.2% ,2/9)(P< 0.01 ).In improving the liver function and PTA,the group A was better than the B.Conclusion: The combination of lamivudine with dexamethasone can improve the liver function and increase the survival rate of the patients with SHB.