不同时期启用拉米夫定对慢性重型乙型肝炎转归的影响

目的 观察慢性重型乙型肝炎患者在不同时期启用拉米夫定治疗的临床疗效及安全性.方法 选择我院2002年4月～2005年12月收治的慢性乙型重型肝炎患者116例(其中早、中期患者分别为64例和52例),根据开始使用拉米夫定治疗的时期不同,分A组62例,B组54例,拉米夫定治疗72周后,分别观察其临床疗效与不良反应,并相互比较.结果 A组患者肝功能指标明显优于B组(P＜0.05);早期患者存活率A组明显高于B组(P＜0.05),中期患者存活率两组无显著性差异(P＞0.05);两组患者病毒学应答率及血清学应答率无显著性差异(P＞0.05).结论 拉米夫定治疗慢性乙型重型肝炎,安全性好;及早使用可以提高早期患者救治成功率,改善患者肝功能;但开始拉米夫定治疗早晚对患者病毒学应答及血清学应答无影响.

The effect of the time of starting lamivudine-treatment in patients with chronic severe hepatitis B(CSHB)

Objective To investigate the efficacy and safety of Iamivudine-treatment starting to use at different time in patients with CSHB.Methods 116 CSHB cases were given lamivudine for 72 weeks,which include 64 forepart cases and 52 metaphase cases, from April 2002 to December 2005 in our hospital.Dividing them into 2 groups, one the A group(62 cases)were given lamivudine at begin, one the B group (54 cases) were gave 8~12 weeks later.Then compared with the difference of efficacy and adverse reactions of the two groups.Results The liver function of the A group was significantly better than that of B group (P<0.05). The survival ratio of the A group was higher than that of B group in the forepart patients(P<0.05).The survival ratio of metaphase patients were almost the same in the two groups (P>0.05).The virologic response rates and serological response rates of the two groups were not significantly different (P>0.05).Conclusion The security of the lamivudine to the patients with CSHB is high. Early use can increase the success ratio of treatment to the patients and liver function. But the time of starting lamivudine treatment has no effect on the virologic response and serological response.