论文部分内容阅读
目的 观察和对比单用拉米夫定与拉米夫定联合α干扰素治疗慢性乙型肝炎的安全性和疗效。方法 拉米夫定组 6 4例 ,单服拉米夫定 ,10 0mg或 15 0mg ,每日 1次 ,其中 5 4例 ( 84.4% )用药超过 12个月。联合组 49例 ,拉米夫定用药 2周后加用干扰素 (甘乐能或罗荛愫 ) ,3MU～ 5MU肌肉或皮下注射 ,每周 3次 ,2 4周后停干扰素 ,继续服拉米夫定 ,其中 38例 ( 77.6 % )治疗超过 12个月。两组在治疗 6个月、12个月时分别进行疗效评价 ,并继续随访 4～ 2 6个月。结果 拉米夫定组和联合组 6个月时ALT/AST复常率分别为 90 .6 % /92 .2 %和 89.8% /93.9% (P >0 .0 5 ) ;HBVDNA阴转率分别为 96 .9%和 98.0 % (P >0 .0 5 ) ;HBeAg的血清转换率为 2 0 .3%和 2 8.6 % (P >0 .0 5 )。 12个月时两组ALT/AST的复常率分别为 90 .7% /90 .7和 89.5 % /92 .1% (P >0 .0 5 ) ;HBVDNA阴转率为 88.9%和 89.5 % (P >0 .0 5 ) ;HBeAg的血清转换率则分别为 31.5 % ( 17/5 4)和 5 5 .3% ( 2 1/38) ,P <0 .0 5。HBeAg的血清转换率似乎与治疗前的转氨酶水平较高、HBeAg和HBVDNA水平较低有关。治疗 9～ 2 4个月期间拉米夫定组 9例 ( 14 .1% )、联合组 6例 ( 12 .2 % )发生HBV多聚酶YMDD变异。结论 拉米夫定和干扰素联合治疗慢性乙型肝?
Objective To observe and compare the safety and efficacy of lamivudine and lamivudine combined with interferon alpha alone in the treatment of chronic hepatitis B. Methods Sixty-four patients in the lamivudine group were treated with lamivudine, 100 mg or 150 mg once daily, of which 54 (84.4%) were treated for more than 12 months. Combined group of 49 cases, lamivudine medication 2 weeks after the addition of interferon (Gan Lok or Luo 荛 愫), 3MU ~ 5MU muscle or subcutaneous injection, 3 times a week, 24 weeks after stopping interferon, continue to service Lamivudine, of which 38 cases (77.6%) were treated for more than 12 months. The two groups were evaluated at 6 months and 12 months respectively, and were followed up for 4 ~ 26 months. Results The ALT / AST at 6 months after lamivudine and combination therapy were 90.6% / 92.2% and 89.8% / 93.9% respectively (P> 0.05), and the rates of negative conversion of HBVDNA were Were 96.9% and 98.0% respectively (P> 0.05). The seroconversion rates of HBeAg were 20.3% and 22.6% (P> 0.05), respectively. At 12 months, the normalization rates of ALT / AST in both groups were 90.7% / 90.7% and 89.5% / 92.1%, respectively (P> 0.05); the negative conversion rates of HBVDNA were 88.9% and 89.5% (P> 0.05). The seroconversion rates of HBeAg were 31.5% (17/5 4) and 53.3% (2 1/38) respectively, P <0.05. The seroconversion rate of HBeAg appears to correlate with higher levels of aminotransferases before treatment and lower levels of HBeAg and HBVDNA. In 9 to 24 months, 9 cases (14.1%) of lamivudine group and 6 cases (12.2%) of combined group occurred HBV polymerase YMDD mutation. Conclusion lamivudine and interferon combined treatment of chronic hepatitis B?