摘要
目的探讨拉米夫定治疗乙型肝炎肝衰竭患者的疗效。方法在182例乙型肝炎肝衰竭患者中,包括亚急性和慢加急/亚急性肝衰竭(A组)患者90例和慢性肝衰竭(B组)92例。在A组患者,40例(A1组)只接受基础和苦参碱治疗,50例(A2组)另加拉米夫定治疗;同样地,在B组中,41例(B1)未接受抗病毒治疗,51例(B2)给予拉米夫定治疗。生存患者被随访6个月。结果经过平均1.5个月的治疗,A1组有23例(57.5%)和A2组有16例(32.0%,P<0.05)患者死亡;经过平均2.5个月的治疗,B1组有22例(53.7%)和B2组有24例(47.1%,P>0.05)患者死亡;在A、B两组内,抗病毒治疗可明显提高生存患者血清ALT的复常率;在随访6个月时,80%以上A2组和B2组生存者HBV DNA水平保持阴性,而A1组和B1组生存者血清HBV DNA仍为阳性。结论拉米夫定治疗能提高亚急性和慢加急/亚急性乙型肝炎肝衰竭患者的生存率,但对慢性乙型肝炎肝衰竭患者的疗效还有待进一步随访。
Objective We conducted a pilot clinical trial to observe the efficacy of lamivudine in the treatment of hepatitis B patients with liver failure.Methods A total of one hundred and eighty-two patients with liver failure caused by hepatitis B were divided into group A（acute-or subacute-on chronic,n=90）and group B（chronic,n=92）.Lamivudine were given for patients in subgroup A2（n=50）and B2（n=51）,while patients in subgroup A1（n=40）and B1（n=41）didn＇t received lamivudine.Patients in every groups were treated with supporting and matrine therapy.Results After a mean period of 1.5 month treatment,23 patients（57.5%）in subgroup A1 and 16 patients（32.0%,P0.05）in subgroup A2 died,whereas after a mean period of 2.5 month treatment,22 patients（53.7%）in subgroup B1 and 24（47.1%,P0.05）in subgroup B2 died;lamivudine therapy improved ALT normalization both in group A and group B;at the end of 6-mon follow up,80% of patients in subgroup A2 and subgroup B2 were with serum HBV DNA negative,while all patients in subgroup A1 and subgroup B1 were with serum HBV DNA positive.Conclusion Lamivudine can improve the survival of patients with acute-or subacute-on chronic hepatitis b-induced liver failure.
出处
《实用肝脏病杂志》
CAS
2010年第6期411-413,共3页
Journal of Practical Hepatology
基金
南京军区联勤部卫生部第十一五重大攻关课题(07Z007-A)
南京军区"122"人才培养基金(122-lA)
关键词
乙型肝炎
肝衰竭
拉米夫定
疗效
Hepatitis B
Hepatic failure
Lamivudine
Efficacy
