摘要
目的 评价国产拉米夫定治疗慢性乙型肝炎患者1年后肝组织学改变。方法 口服拉米夫定100mg,每日1次,疗程1年,治疗前、后均接受肝穿刺活检的慢性乙型肝炎患者101例。按照Kondell组织学活动指数(HAI)双盲评价肝组织学改变。结果 治疗后53.5％(54/101)患者肝组织学改善(治疗后HAI积分下降≥2),HAI积分由治疗前的8.0±4.7下降至治疗后5.2±3.3(t=7.358,P<0.01);其中51.5％(52/101)患者坏死炎症程度改善(治疗后积分下降≥2),坏死炎症积分由5.9±3.8下降至3.6±2.5;31.7％(32/101)患者纤维化程度改善(治疗后积分下降≥1),纤维化积分由2.1±1.2下降至1.6±1.2(t-3.827,P<0.01)。无论治疗结束是否发生乙型肝炎病毒e抗原血清转换,患者的肝脏组织学均明显改善。结论 国产拉米夫定治疗慢性乙型肝炎1年后,肝组织学的坏死炎症和肝纤维化程度均获明显改善。
Objective To investigate the histological changes in liver biopsy tissues taken from chronic hepatitis B patients with HBsAg and HBeAg positive and ALT abnormal after lamivudine therapy for one year. Methods Lamivudine was given orally at the dose of 100 mg once a day for one year. 101 patients were enrolled into this open-label study. Paired liver biopsies from patients with hepatitis B before and after therapy with lamivudine were studied. Blinded biopsies were evaluated by a histopathologist and scored according to Knodell's histology activity index(HAI). Results 53.5% (54/101), 51.5% (52/101) and 31.7% (32/101) patients had a reduction of their total hepatic HAI score, necroinflammation and fibrosis scores by≥2 points or 1 points at the end of one year of lamivudine therapy, compared with their pretreatment values, respectively. There were significant reduction of HAI score, necroinflammation and fibrosis scores from 8.0±4.7 to 5.2±3.3 (t = 7.358, P < 0.01), from 5.9±3.8 to 3.6±2.5 (t = 7.298, P < 0.01), and from 2.1±1.2 to 1.6±1.2 (t = 3.827, P < 0.01), respectively. The histological improvement was independent on the HBeAg seroconvertion during the therapy. Conclusion Significant improvement in liver histology, both necroinflammation and fibrosis, can be obtained in the majority of patients treated with lamivudine for one year.
出处
《中华肝脏病杂志》
CAS
CSCD
2003年第9期555-557,共3页
Chinese Journal of Hepatology
