医药前沿
醫藥前沿
의약전연
YIAYAO QIANYAN
2012年
35期
59-60
,共2页
肺结核%乙型肝炎病毒携带者%药物性肝炎%拉米夫定
肺結覈%乙型肝炎病毒攜帶者%藥物性肝炎%拉米伕定
폐결핵%을형간염병독휴대자%약물성간염%랍미부정
pulmonary tuberculosis%hepatitis B virus carriers%drug hepatitis%Lamivudine
目的观察拉米夫定对乙肝携带者抗结核治疗中肝损害的预防治疗疗效.方法收集我院乙肝携带并有肺结核好(A)组30例,及未进行抗病毒治疗的乙肝携带并有肺结核患者(B 组)25例,两组开始抗结核治疗时均采用2HRZE/4HR 化疗方案.A 组给予水飞蓟宾护肝治疗和拉米夫定抗病毒治疗;B 组仅给予水飞蓟宾护肝治疗.观察两组治疗前后肝功能与 HBV-DNA 变化情况.结果 A 组治疗中不良事件发生率明显低于 B 组(P <0.05).治疗前 A、B 两组肝功能与 HBV-DNA 水平差异无统计学意义(P <0.05),A 组治疗后 HBVDNA(log)水平为(3.68±1.04),与治疗前的(6.74±2.54)比较差异有统计学意义(P <0.05).B组治疗后 ALT、AST 增高,与治疗前及治疗后 A 组比较差异有统计学意义(P <0.05).结论乙肝携带合并肺结核患者使用拉米夫定抗病毒治疗可以有效抑制患者体内 HBV 的复制,预防肝功能损害,可以支持化疗顺利进行.
目的觀察拉米伕定對乙肝攜帶者抗結覈治療中肝損害的預防治療療效.方法收集我院乙肝攜帶併有肺結覈好(A)組30例,及未進行抗病毒治療的乙肝攜帶併有肺結覈患者(B 組)25例,兩組開始抗結覈治療時均採用2HRZE/4HR 化療方案.A 組給予水飛薊賓護肝治療和拉米伕定抗病毒治療;B 組僅給予水飛薊賓護肝治療.觀察兩組治療前後肝功能與 HBV-DNA 變化情況.結果 A 組治療中不良事件髮生率明顯低于 B 組(P <0.05).治療前 A、B 兩組肝功能與 HBV-DNA 水平差異無統計學意義(P <0.05),A 組治療後 HBVDNA(log)水平為(3.68±1.04),與治療前的(6.74±2.54)比較差異有統計學意義(P <0.05).B組治療後 ALT、AST 增高,與治療前及治療後 A 組比較差異有統計學意義(P <0.05).結論乙肝攜帶閤併肺結覈患者使用拉米伕定抗病毒治療可以有效抑製患者體內 HBV 的複製,預防肝功能損害,可以支持化療順利進行.
목적관찰랍미부정대을간휴대자항결핵치료중간손해적예방치료료효.방법수집아원을간휴대병유폐결핵호(A)조30례,급미진행항병독치료적을간휴대병유폐결핵환자(B 조)25례,량조개시항결핵치료시균채용2HRZE/4HR 화료방안.A 조급여수비계빈호간치료화랍미부정항병독치료;B 조부급여수비계빈호간치료.관찰량조치료전후간공능여 HBV-DNA 변화정황.결과 A 조치료중불량사건발생솔명현저우 B 조(P <0.05).치료전 A、B 량조간공능여 HBV-DNA 수평차이무통계학의의(P <0.05),A 조치료후 HBVDNA(log)수평위(3.68±1.04),여치료전적(6.74±2.54)비교차이유통계학의의(P <0.05).B조치료후 ALT、AST 증고,여치료전급치료후 A 조비교차이유통계학의의(P <0.05).결론을간휴대합병폐결핵환자사용랍미부정항병독치료가이유효억제환자체내 HBV 적복제,예방간공능손해,가이지지화료순리진행.
Objective To evaluate theefficacy of Lamivudine in preventing liver dysfunction in hepatitis B carriers with anti-tuberculosos treatment. Methods Research group (groupA) included 30 eases of hepatitis B carriers with pulmonary tuberculosis. Control group (group B) incoded25 cases of hepatitis B carriers with pulmonary tuberculosis, but without receiving anti-virus therapy.Both group A and group B were given with anti-tuberculosis drugs (2HRES/4HR) at the beginning of the study. In addition,group A was given with Silibinin to protect the liver funtion and and Lamivudine for the anti-hepatitis B treatment.Silibinin was only given to group B.Rifampicin was replaced with R ifapentine in several cases with severeliver dysfunction during treatment.The change of liwer function and HBV DNA level were observed before and after chemotherapy.Results The ratio of adverse events in group A was much less than that in group B (P < 0.05). No obvious different in the liver function between group A and B before therapy (P < 0.05).ALT and AST were increased in group B after chemotherapy,and the results were ststisticaly significant different from those before and after therapy in group A (P < 0.05). Conclusion Lamivudine is effective in suppressing duplication of HBV DNA and preventing liver dysfuntion in hepatitis B carriers with anti-tuberculosis therapy.
