CAJ | 학술논문

目的：观察拉米夫定联合泼尼松对结核性胸膜炎伴 HBV 感染患者临床治疗效果。方法：选择结核性胸膜炎合并乙肝病毒（HBV）感染患者75例，采用区组随机化法分为治疗组38例及对照组37例，两组均给予3HREZ ／9HRE 抗结核治疗，治疗组加用拉米夫定及泼尼松治疗；观察两组患者治疗前及治疗3、6月 HBV －DNA、肝功能及胸水消失时间、胸膜粘连增厚发生情况。结果：治疗3、6月后，治疗组 HBV －DNA 逐渐下降，对照组无明显改变，治疗组 HBV －DNA 水平明显低于对照组（P ＜0.05）；治疗组肝功能损害发生率为15.15％，对照组为43.24％，肝功能损坏发生率明显低于对照组（P ＜0.01）。治疗组胸水吸收时间，明显短于对照组（P ＜0.05）。胸膜粘连、增厚发生率治疗组明显小于对照组（P ＜0.05）。结论：拉米夫定联合泼尼松治疗结核性胸膜炎伴 HBV 感染患者，既可防治患者HBV 的复制和肝功能的损害，又有利于胸水吸收及防止胸膜增厚、粘连。
목적：관찰랍미부정연합발니송대결핵성흉막염반 HBV 감염환자림상치료효과。방법：선택결핵성흉막염합병을간병독（HBV）감염환자75례，채용구조수궤화법분위치료조38례급대조조37례，량조균급여3HREZ ／9HRE 항결핵치료，치료조가용랍미부정급발니송치료；관찰량조환자치료전급치료3、6월 HBV －DNA、간공능급흉수소실시간、흉막점련증후발생정황。결과：치료3、6월후，치료조 HBV －DNA 축점하강，대조조무명현개변，치료조 HBV －DNA 수평명현저우대조조（P ＜0.05）；치료조간공능손해발생솔위15.15％，대조조위43.24％，간공능손배발생솔명현저우대조조（P ＜0.01）。치료조흉수흡수시간，명현단우대조조（P ＜0.05）。흉막점련、증후발생솔치료조명현소우대조조（P ＜0.05）。결론：랍미부정연합발니송치료결핵성흉막염반 HBV 감염환자，기가방치환자HBV 적복제화간공능적손해，우유리우흉수흡수급방지흉막증후、점련。
Objective To Study the effect of lamivudine combined with prednisone on HBV -DNA ,liver function and treatment in tuberculous pleurisy patients complicated with HBV infection.trying to find the treatment strategy.Methods Seventy -five tubercu-lous pleurisy patients complicated with HBV infection were randomly divided into treatment group 38 cases and control group 37 cases, two groups were given 3HREZ /9HRE,The treatment group was treated with lamivudine and prednisone;observe the lever of HBV -DNA ,the liver function Before and after treatment;observe the time of hydrothorax disappearance and the incidence rate of pleural thicken or adhesion.Results The levels of HBV -DNA in treatment group were significantly lower than those of the control group after 3 months and 6 months (P <0.05),liver function damage was significantly lower than the control group (P <0.05).The incidenc rate of plura incrassation and adhesions is lower in the treatment group (P <0.05),and the time of pleural effusion absorption was shorter in treatment group (P <0.05 ).Conclusion Lamivudine combined with prednisone can prevent HBV replication and liver function damage in tuberculous pleurisy patients complicated with HBV infection.It is effective method to treat tuberculous pleurisy worthing to further clinical investigation.