拉米夫定治疗肝衰竭8年随访

目的为了解拉米夫定治疗乙型肝炎肝衰竭的远期疗效。方法回顾性分析了应用拉米夫定联合血浆置换治疗的乙型肝炎肝衰竭26例，观察近期疗效及8年后随访结果。结果应用拉米夫定治疗组14例，近期治愈好转率明显高于对照组，x^2=26．1，P〈0．01。拉米夫定治疗组中持续用药者无肝硬化发生，与停止治疗及间断治疗者比较，差异非常显著，P〈0．01。对照组近期治愈好转8例中，5例发病时HBVDNA阴性、抗-HBe阳性，选择不抗病毒治疗，后期发生肝硬化、肝癌比例明显高于HBV DNA阳性应用拉米夫定者，具统计学差异。持续用药组无肝硬化发生，与停止治疗及间断治疗组比较，差异非常显著，P〈0．01。结论抗病毒治疗可提高乙型肝炎肝衰竭近期治愈好转率，并降低远期不良预后。发病期HBV DNA载量做为抗病毒治疗依椐有待进一步探讨。

Lamivudine treatment liver failure with 8-year follow-up

Objective To understand the long-term effect of the Lamivudine treatment hepatitis B liver failure. Methods Retrospective analysis between February 2001 and February 2002 the application of plasma exchange united Lamivudine treatment for hepatitis B in patients with 26 cases of liver failure, whether in Lamivudine by supporting antiretroviral therapy will be short-term efficacy and division observed after 8 years follow-up. Results Lamivudine was used in the treatment group of 14 cases,the recent improvement in cure rate was significantly higher than the control group,x^2= 26.1,P〈0.01. Lamivudine treatment group which supports drug goes without cirrhosis, is much better than the patients that stop treatment and intermittent treatment,P〈0.01. The recent cured 8 cases in the control group,of which 5 cases when the disease represented HBVDNA negative,anti-HBe positive and did not choose anti-viral treatment. Consequently, the following symptom of liver cirrhosis,with statistical significance,liver cancer was significantly higher than the group of the positive HBVDNA Lamivudine users, continuing medication was no cirrhosis,and to stop treatment and intermittent treatment group,the difference was significant. Conclusion To improve the rate of cure and reduce the adverse longterm prognosis at anti-viral therapy for hepatitis B liver failure. Onset phase HBVDNA load as noted in accordance with antiretroviral therapy remains to be further explored.