拉米夫定治疗慢性乙型肝炎疗效观察

目的观察拉米夫定治疗慢性乙型肝炎疗效及不良反应。方法将慢性乙型肝炎患者121例随机分成观察组69例和对照组52例，观察组给予拉米夫定100mg，口服，1次／日。对照组给予a-2b干扰素300万IU，肌注，1次／日。两周后改为隔日1次。两组均辅以维生素族及一般护肝药，治疗期间不加用其他抗病毒药物。经治疗一年后，观察两组的临床疗效（观察两组血清A坍复常率、HBeAg转阴率及血清HBV—DNA阴转率）及不良反应。对照组与治疗组的复常率及阴转率进行zz检验。结果治疗一年，观察组血清ALT复发率为91．30％（63／69）；HBeAg阴转率为52．17％（36／69）；血清HBV—DNA阴转率为86．96％（60／69）。对照组血清AIJrr复常率为42．31％（22／52）；HBeAg阴转率为30．77％（16／52）；HBV—DNA阴转率为48．08％（25／52），比较差异均有显著性（Jp〈0．05）。且拉米夫定的副作用低于a-2b干扰素。结论拉米夫定是治疗慢性乙型肝炎安全有效药物，连续用药1年，肝功能复常、病毒转阴及血清学转换显著，均优于干扰素，值得临床推广。

Observation on the curative effect of lamivudine in the treatment of chronic hepatitis b

Objective To observe the curative effect and harmful reactions of lamivudine in the treatment of chronic hepatitis B. Methods A total of 121 cases patients with hepatitis B were at random divided into observation group of 69 cases and control group of 52 cases. The patients in the observation group oralIy took the laminvudine of 100 mg, one time a day. The patients in the control group were carried out the muscle injection of recombinant human interferon a-2b of 3,000,000 IU, one time a day. 2 weeks later,it was one time every other day. The vitamins and general hepatoprotectants were all additionally used in the observation group and control group and without the other anti-virus drugs added. After one-year's treatment,the curative effects ( serum ALT recovery rate, HBeAg negative conversion rate and serum HBV DNA negative conversion rate ) and harmful reactions in two groups were observed. The χ2 test for recovery rates and negative conversion rates in the control group and treatment group had been carried out. Results After one-year's treatment, the serum ALT recovery rate was 91.30% ( 63/69 ), HBeAg negative conversion rate was 52.17% ( 36/69 ) and serum HBV DNA negative conversion rate was 86.96% ( 60/69 ) in the observation group. In the control group, the serum ALT recovery rate was 42.31% ( 22/52 ), HBeAg negative conversion rate was 30.77% ( 16/52 ) and serum HBV DNA negative conversion rate was 48.08% ( 25/52 ). The differences had statistical significance (P＜0.05). The by-effect of lamivudine was lower than that of recombinant human interferon a-2b. Conclusions The lamivudine is an effective drug in the treatment of chronic hepatitis B. After one-year's successive treatment, the liver function becomes normal, viruses become negative and the sero-conversion is obvious. All of these are better than interferon. Therefore, it is valuable for clinical popularization.