使用激素的乙肝病毒相关性肾炎拉米夫定治疗的耐药性分析

目的拉米夫定耐药对乙肝病毒相关性肾炎治疗的影响。方法 36例HBV相关性肾炎患者同时使用激素及拉米夫定治疗,24周时HBVDNA定量较治疗前下降分为A组23例,上升或不变设为B组13例,测定治疗前及治疗24周、48周时的24h尿蛋白定量,肝肾功能,HBV-DNA定量。结果治疗48周后两组尿蛋白定量下降,血浆白蛋白升高,与治疗前比较差异有统计学意义（P〈0.05）,但两组之间比较差异无统计学意义（P〉0.05）;两组治疗前后及两组间血肌酐、谷丙转氨酶比较差异无统计学意义（P〉0.05）。结论 24周时拉米夫定耐药的乙肝病毒相关性肾炎患者继续单用该药,仍能取得较好疗效。

Analysis of lamivudine resistance in hepatitis B virus associated-glomerulonephritis patients with therapy of lamivudine plus steroid

Objective To evaluate the influence of lamivudine resistance on hepatitis B virus associated-glomerulonephritis （ HBV-GN） therapy. Methods 36 patients with HBV-GN were enrolled into combination therapy of lamivudine plus steroid. 24 Cases whose HBV-DNA sequences decreased after 24-week lamivudine treatment were divided into A group,13 cases into B group otherwise. Protein in urine per day,liver and renal function,as well as HBV-DNA sequences were detected prior to treatment,after 24-week treatment and 48-week treatment respectively. Results Compared to the figures prior to treatment,quantity of protein in urine dropped significantly and serum albumin level increased significantly after 48-week treatment in either A or B group. Nevertheless,there was no significance when data in two groups were compared to each other. There was no significance when Serum creatine and glutamic-pyruvic transaminase in each group were compared before and after therapy,and data in two groups were compared to each other. Conclusion Comparatively satisfactory outcome might be expected in lamivudine-resistant patients with HBV-GN when medicine continued.