拉米夫定治疗活动性肝炎肝硬化疗效观察.doc

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1、拉米夫定治疗活动性肝炎肝硬化疗效观察作者：罗水保，粟庆娟，吕齐法，毛红霞，樊小慧【关键词】肝炎肝硬化【摘要】目的观察拉米夫定对活动性肝炎肝硬化的治疗效果，寻求治疗活动性肝炎肝硬化的有效方法。方法选择34例活动性肝炎肝硬化患者，口服拉米夫定100mg，每日1次，疗程12个月。观察治疗前后临床症状、体征、生化指标、病毒学指标、血清肝纤维化标志物以及肝门静脉的宽度、脾静脉的宽度和脾脏厚度变化情况。结果83.9%(26/31)的患者治疗后病情稳定，生活质量提高。表现为腹水消失或明显减少，黄疸消退或总胆红素明显下降，血清白蛋白升高，丙氨酸氨基转移酶复常或好转

2、。HBV-DNA阴转率51.6%(16/31),HBeAg阴转率33.3%(7/21>>血清肝纤维化标志物：透明质酸(HA山型前胶原(PCIIIXIV型胶原(CIV)明显改善(P<0.01)b肝门静脉宽度、脾静脉宽度变窄，部分病例原肿大的脾脏缩小。结论对于有病毒复制的活动性肝炎肝硬化患者应用拉米夫定治疗，可以改善肝脏功能，延缓或阻止肝硬化进展，减少并发症，提高生活质量。【关键词】肝炎肝硬化；拉米夫定；抗病毒治疗Theobservationoftheraputiceffectoflamivudineintreatmentofhepatitiswit

3、hhepaticcirrhosis[Abstract]ObjectiveObservethetherapeuticeffectbyusinglamivudineintreatmentofhepatitiswithhepaticcirrhosisinordertoseekfortheeffectivetreatmenttoactivehepatitiswithhepaticcirrhosis.Methods34patientssufferingactivehepatitiswithhepaticcirrhosiswerechosen.Duringth

4、ecoursewhichlasted12months,theywereaskedtotake100mglamivudineorallyonceeveryday.CIinicalsymptoms,bodysigns,"dexesofbio-chemistry,virusindexes,andthechangesofsymbolsofserumliverfibrosis,thewidthofhepaticportalvEin,thewidthofsplenicvEln,thethicknessofspleenbeforeandafterthetreat

5、ment.Results83.9%(26/31)ofthepatients1conditionbecamestableaftertreatmentandtheirlivingqualitieswereraised.Thedetailswerethatascitesdisappearedorwasreducedobviously.Jaundiceortotalbilirubinfaded.albumin「ose,alanineaminotransaminase,ALTgotrecoveredorimproved.TherateofHBV-DNAneg

6、ative-transformingis51.6%(16/31)andHBeAgis33.3%(7/21).Symbolsofserumliverfibrosis:hyaluronioacid(HA),pre-collagenIII(PCIII),collagenIV(CIV)wereobviouslyimproved.Thewidthofhepaticportalveinandthewidthofsplenicveingotnarrowed.Theswollenspleensinsomecasesshrank.ConclusionUsinglam

7、ivudineintreatmentofhepatitiswithhepaticcirrhosisthatcancopyviruscanimprovetheliverfunctionanddelayorpreventtheprogress!onofhepaticcirrhosis.Atthesametimecomplicationscanbereducedandthelivingqualitiesberaised.【Keywords]hepatitiswithhepaticcirrhosis;lamivudine;anti・virustherapy

8、拉米夫定对于具有病毒活跃复制的慢性乙型肝炎的治疗效果已得到广泛而充分的证实。随着人们对拉米夫定认识的逐步深入，拉米夫定的治