男性肝硬化代偿期患者拉米夫定治疗后性激素的变化.pdf

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1、i84TianjinMedJ．Feb2014。Vol42No2男性肝硬化代偿期患者拉米夫定治疗后性激素的变化潘永平邱梦标毛红霞樊晓慧粟庆娟熊水印龚辉【摘要】目的探讨拉米夫定治疗男性代偿期乙肝肝硬化患者过程中性激素的变化及其意义。方法选择代偿期乙肝肝硬化男性患者46例为研究对象，给以拉米夫定抗病毒治疗24周，比较治疗前后的性激素水平差异。根据24周的应答情况，分为两组(完全应答组和非完全应答组)，比较两组患者治疗后的性激素水平差异。结果(1)拉米夫定抗病毒治疗后男性代偿期乙肝肝硬化泌乳素较治疗前明显下降，睾酮、雌二醇水平明显升高。(2)治疗后完全应答组和非完全应答组泌乳素

2、、睾酮、雌二醇水平差异有统计学意义。结论(1)拉米夫定抗病毒治疗可以改善男性代偿期乙肝肝硬化的性激素功能紊乱。(2)性激素功能紊乱的改善与否与24周时的应答情况有一定关系。【关键词】肝炎，乙型；肝硬化；拉米夫定；激素类；雌二醇；男(雄)性【中图分类号】R657．3+1【文献标识码】A【DOI】10．3969／j．issn．0253—9896．2014．02．026TheSignificanceofChangesinSexHormonesafterLamivudineAntiviralTreatmentforHepatitisBinMalePatientswithComp

3、ensatedCirrhosisPANYongping，QIUMengbiao，MAOHongxia，FANXiaohui，SUQingjuan，XIONGShuiyin，GONGHuiDepartmentofInfection，TheAffiliatedForthHospitalofNanchangUniversity，Nanchang330003，China【Abstract】ObjectiveToinvestigatethechangesofsexhormonesafterlamivudineantiviraltreatmentinmalehepa—titisBp

4、atientswithcompensatedcirrhosis，andthesignificanceofchangesthereof．MethodsForty—sixmalepatientswithcompensatedcirrhosiswereincludedinpatientgroup．Thepatientgroupwasgivenlamivudineantiviraltreatmentfor24weeks．Thesexhormonelevelswerecomparedbetweenbeforeandaftertreatment．Patientsweredivide

5、dintotwogroups(completeresponsegroupandincompleteresponsegroup)accordingtotheirresponsetothetreatment．Thesexhormonelev—elswerecomparedbetweenthesetwogroups．Results(1)ThelevelofPRLwassignificantlydecreased。andthelevelsofTandE2weresignificantlyincreasedafterlamivudineantiviraltreatmentinpa

6、tientgroup．(2)Thereweresignificantdiferenc—esinlevelsofPRL，TandE2betweencompleteresponsegroupandincompleteresponsegroup．Conclusion(1)Thelami—vudineantiviraltreatmentcanimprovethedysfunctionofsexhormones．(2)Therewasarelationshipbetweenthechangesofsexhormonesandtheresponsesofantiviraltreat

7、ment．【Keywords】hepatitisB；livercirrhosis；Lamivudine；hormones；estradiol；male肝硬化患者常伴有性功能减退及男性女性化，门诊接受拉米夫定抗病毒治疗的男性代偿期乙肝肝硬化患医学上称为肝硬化男性性功能减退综合征，又称内者46例，诊断和抗病毒适应证依照慢性乙型肝炎防治指南(2010版)。年龄37—56岁，中位年龄44．5岁，病程7—15分泌缺乏一肝硬变综合征(Silvestrini—corda综合年，中位病程12年，HBV-DNAlx103~1x106copy／mL。征)。传