拉米夫定治疗失代偿肝炎后肝硬化的临床研究

目的观察拉米夫定治疗失代偿肝炎后肝硬化患者的临床疗效和安全性。方法31例失代偿肝炎后肝硬化患者,随机分组:治疗组16例拉米夫定治疗24~54月(平均33月),对照组15例常规治疗24~52月(平均32月),观察临床表现、血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、白蛋白(Ab)和总胆红素(Tb il)、凝血酶原时间(PT)、HBV-DNA(荧光定量PCR法)、B超以及ch ild-pugh积分的变化。结果治疗组除2例因并发症死亡,其余14例临床表现明显改善,肝功能明显好转,HBV-DNA均小于1000拷贝/毫升,ch ild-pugh积分降低(均P<0.01)。而对照组除6例因并发症死亡,其余9例无显著改变。所有患者治疗中均无明显毒副反应发生。结论长期拉米夫定治疗失代偿肝炎后肝硬化,能快速有效抑制HBVD-NA,阻止肝细胞损伤,改善肝功能和生活质量,是一种安全,有效的治疗方法。

Clinical study of lamivudine treatment on patients with dencompensated cirrhosis post hepatitis

OBJECTIVE To observe the efficiency and safety of long-term lamivudine used in dencompensated cirrhosis following chronic hepatitis B.METHODS 31 patients with dencompensated cirrhosis were divided randomly into two grops:sixteen patients with dencompensated cirrhosis received lamivudine 100mg daily for period 24~54 months.The changes were observed and detectived before lamivudine treatment,and compared with lamivudine treatment including clinical status,ALT,AST,Ab,Tbil,PT and HBVDNA levels,child-pugh score,and compared with the control group without lamivudine treatment for period 24~52 months. RESULTS After the treatment of lamivudine,there were fourteen patients whose clinical symptoms,signs and liver function(include ALT,AST,Ab,Tbil and PT) improved(P<0.01),and HBVDNA levels decreased at least 10~(3) copies/ml(P<0.01),child-pugh score declined(P<0.01),except two patients died with complications.In the control group,nine patients didn't improve in clinical status and liver function(P>0.05),except six patients died with complications.CONCLUSION Long-term lamivudine treatment on dencompensated cirrhosis following chronic hepatitis B could decrease drastically HBVDNA levels,prevent hepatocellular from damage,it is an significantly effective and safty drug that improved liver function and life quality.