选择性血浆置换联合拉米夫定治疗慢性重型乙型肝炎的临床研究

目的：探讨选择性血浆置换（PPE）联合拉米夫定（3TC）抗病毒治疗慢性重型乙型肝炎的临床疗效。方法：将69例慢性重型乙型肝炎患者随机分为治疗组34例，对照组35例。治疗组用PPE联合3TC治疗，加内科治疗；对照组仅予以内科治疗。两组治疗前后比较临床治愈好转率。并观察主要肝功能、凝血功能及HBVDNA定量检测的变化。结果：治疗结束后，治疗组总有效率为85．3％，疗效优于对照组的28．6％。且治疗组TBiL、ALB、ALT、CHE、PTA、HBVDNA等实验室指标的定量检测均较对照组有明显改善（P〈0．05）；同时治疗组治疗前后其肝功能、凝血功能与HBVDNA定量检测也有显著改善（P〈0．01）。结论：PPE联合3TC治疗慢性重型乙型肝炎有较好疗效。

Clinical Research on Part Plasma Exchange with Lamivudine in Treating Severe Chronical Type B Hepatitis

Objective:Toevaluate the clinical efficacy of part plasma exchange(PPE) with lamivudine(3TC) in treating severe chronical type B hepatitis.Methods:69 cases of severe chronical type B hepatitis were randomly divided into two groups:treatment group(n=34) and control group(n=35).Treatment group received PPE and 3TC based on medical treatment.Control group received only medical treatment.In both groups,the improvement rate before and after treatment were observed,and the liver function,blood clotting function and HBVDNA wre detected.Results:The total effective rate in treatment group was superior to that in control group(85.3% vs 28.6%).In treatment group,the levels of TBiL,ALB,ALT,CHE,PTA and HBVDNA obviously improved when compared with controls(P<0.05);the liver function,blood clotting function and HBVDNA also improved after treatment(P<0.01).Conclusion:PPE and 3TC is effective in treating severe chronical type B hepatitis.