摘要
目的 评价拉米夫定或联用α 干扰素治疗慢性乙型肝炎终点后的效果。 方法 对 10 2 0例接受拉米夫定或联用α 干扰素治疗病人终点后 6个月进行随访 ,并作统计分析。 结果 (1)拉米夫定治疗组完全应答率为44 94% ,拉米夫定加α 干扰素治疗组为 5 0 78% ,P <0 0 1;(2 )拉米夫定治疗HBVDNA高含量效果明显 ,拉米夫定加α 干扰素治疗HBVDNA低含量效果好 ;(3 )短病程治疗效果优于长病程 ;(4 )治疗后加重病例多为长病程、HBVDNA高含量及单用拉米夫定的男性病人 ,发生严重急性恶化病例 5例 ,仅占总病例 0 49%。 结论 (1)抗病毒药物拉米夫定与α 干扰素联合应用较单一拉米夫定治疗效果好 ,发生治疗后加重反应和较少 ,但需个体化 ;(2 )为避免发生严重急性恶化病例 ,停用拉米夫定后应严密随访ALT及HBVDNA ,特别是停药后 2个月内。一旦发生严重急性恶化 ,除积极护肝治疗外 。
Objective To evaluate the results in treatment of 1 020 chronic hepatitis B patients with lamivudine(LAM) alone and lamivudine combined with alpha interferon at the end of treatment Methods 1 020 hepatitis B patients were treatment with lamivudine alone and lamivudine combined with alpha interferon at the end of treatment Follow-up was made six months after treatment and the results were statistically analyzed Results 1) The complete response rate was 44 9% in lamivudine group and 50 78% in lamivudine plus alpha interferon group Significant differences were observed between the two groups (P<0 01) 2) The Lamivudine alone is apparently effective on patients with high serum HBV DNA level; while the combined therapy of lamivudine plus alpha interferon is more effective on patients with low serum HBV DNA level; 3) the therapeutic effect on patients with short course is better than that with long course; 4) those who's health condition aggravated after treatment are male patients with long course, high HBV DNA level and treated with lamivudine alone, including 5 severe acute exacerbation (SAE) patients accounted for 0 49% of the total number of patients Conclusion 1) The therapeutic effect of lamivudine in combination with alpha interferon is better than that using lamivudine alone There few aggravated patients were observed in both groups of the study and it depends on patients' individual conditions in selecting combined therapy or monotherapy; 2) To avoid the occurrence of SAE patients, ALT and HBV DNA level in the patients be carefully followed up after stopping administration of lamivudine, especially within two months after stopped use of lamivudine The drugs for protecting liver and antiviral therapy be used in case there is SAE patients
出处
《中国热带医学》
CAS
2004年第2期153-155,共3页
China Tropical Medicine
