CAJ | 학술논문

目的：评价拉米夫定联合还原型谷胱甘肽预防乙型病毒性肝炎（乙肝）合并肺结核患者肝功能损伤中的疗效。方法入选94例乙肝合并肺结核患者，分为试验组47例和对照组47例，试验组口服拉米夫定每次0.1 g，每天1次，联合还原型谷胱甘肽每次0.4 g，每天3次；对照组口服拉米夫定每次0.1 g，每天1次。观察2组患者治疗前后肝功能指标，肝纤维化指标，临床疗效及不良反应情况。结果治疗后，2组患者的谷草转氨酶、谷丙转氨酶、总胆汁酸、总胆红素、Ⅳ型胶原、层黏连蛋白、透明质酸酶、Ⅲ型前胶原均较治疗前有所下降（ P＜0.05），但试验组下降更明显（ P＜0.05）。治疗前，2组患者的HBV-DNA载量差异无统计学意义（ P>0.05）；治疗后3，6，10周，试验组HBV-DNA载量均显著低于对照组（ P ＜0.05）。试验组临床总有效率显著高于对照组（ P＜0.05）。2组患者均无严重的不良反应发生。结论拉米夫定联合还原型谷胱甘肽预防乙肝合并肺结核患者肝功能损伤的临床疗效显著，肝功能恢复良好。
목적：평개랍미부정연합환원형곡광감태예방을형병독성간염（을간）합병폐결핵환자간공능손상중적료효。방법입선94례을간합병폐결핵환자，분위시험조47례화대조조47례，시험조구복랍미부정매차0.1 g，매천1차，연합환원형곡광감태매차0.4 g，매천3차；대조조구복랍미부정매차0.1 g，매천1차。관찰2조환자치료전후간공능지표，간섬유화지표，림상료효급불량반응정황。결과치료후，2조환자적곡초전안매、곡병전안매、총담즙산、총담홍소、Ⅳ형효원、층점련단백、투명질산매、Ⅲ형전효원균교치료전유소하강（ P＜0.05），단시험조하강경명현（ P＜0.05）。치료전，2조환자적HBV-DNA재량차이무통계학의의（ P>0.05）；치료후3，6，10주，시험조HBV-DNA재량균현저저우대조조（ P ＜0.05）。시험조림상총유효솔현저고우대조조（ P＜0.05）。2조환자균무엄중적불량반응발생。결론랍미부정연합환원형곡광감태예방을간합병폐결핵환자간공능손상적림상료효현저，간공능회복량호。
Objective To study the effect of lamivudine combined with reduced glutathione on preventing hepatic impairment in patients with hepatitis B virus ( HBV ) complicating pulmonary tuberculosis . Methods A total of 94 cases of patients with HBV complicating pulmonary tuberculosis were divided into experimental group and control group, with 47 cases in each. Patients in experimental group were administered with lamivudine 0.1 g once a day combining with reduced glutathione 0.4 g 3 times a day. Patients in control group were administered with lamivudine 0.1 g once a day . Results After treatment, aspartate aminotransferase, alanine aminotransferase, total bile acid, total bilirubin, Ⅳ collagen, laminin, hyaluronidase, Ⅲprocollagen reduced in both 2 groups ( P<0.05 ) .The above indexes reduced more significantly in experimental group ( P <0.05 ) .Before treatment, there was no significant difference of HBV -DNA load between the 2 groups (P>0.05).After 3, 6 and 10 weeks treatment, HBV-DNA load in experimental group was significantly lower than that in control group (P<0.05).The total effective rate in experimental group was significantly higher than that in control group ( P <0.05 ) . There was no obvious adverse effects in both groups .Conclusion The effect of lamivudine combined with reduced glutathione tablet on preventing hepatic impairment in patients with HBV complicating pulmonary tuberculosis is significant .And hepatic function recovered well .